Impact Of Chronic Pain Research Articles

Exploring driving behaviour from the perspectives of individuals with chronic pain and health professionals

Chronic pain affects one in five Australians, and this could impact daily activities such as driving. Driving is a complex task, which requires the cognitive and physical ability to predict, identify, and respond to hazards to avoid crashing. However, research exploring the factors that influence safe driving behaviour for chronic pain individuals is limited. A qualitative study was conducted which involved semi-structured interviews with 23 people who had experienced persistent pain for at least three months and 17 health professionals who had experience working with individuals with chronic pain. The aim of this study was to obtain a deeper understanding of the experiences and challenges that people with chronic pain may have in their day-to-day driving. Participants were also asked about currently available driving assessments and strategies for individuals with chronic pain in the Australian healthcare system. The themes emerging from the interviews highlighted the need for clearer guidelines and educational materials regarding the impact of chronic pain on an individual's ability to drive. These themes included the physical and cognitive challenges resulting from chronic pain, as well as the potential side effects of pain medications. In addition, participants identified a number of self-regulation strategies and driving assessments currently available for monitoring safe driving behaviour in Australia. This study improves our understanding of how chronic pain affects driving behaviour, as reported by individuals experiencing the pain and relevant health professionals. Recommendations for improving the safety of drivers with chronic pain are discussed, including possible technological interventions and better public education.

Temporomandibular Disorders. Part 1: Anatomy, Aetiology, Diagnosis and Classification

Temporomandibular disorders (TMD) are the most common causes of chronic pain in the orofacial region. The aetiology of TMD is complex owing to its multifactorial biopsychosocial nature. TMD shares many commonalities, and can be associated with, other chronic pain conditions. The physical and psychological impact of chronic pain on the individual can be far-reaching and should not be underestimated. This article, the first of a six-part series, aims to provide the reader with a background to TMDs as well as an overview of the clinical examination and diagnostic process for patients presenting with TMD-related pain. CPD/Clinical Relevance: Clinicians should be aware of the signs and symptoms of TMD with which their patients might present and understand the complex nature of chronic pain conditions.

Clinical and Psychological Impact of Chronic Pain in People with Chronic Obstructive Pulmonary Disease.

PurposeThe presence of pain can be associated with an exaggerated negative cognitive and emotional response, leading to worsening of existing symptoms. This study aimed to describe the multifaceted impact of chronic pain on cognition, emotional and physical health in people with chronic obstructive pulmonary diseases (COPD) and to explore the clinical impact of pain.Patients and MethodsA prospective, cross-sectional multicenter study was carried out in 68 people with COPD (COPD group) and 65 community-dwelling age-matched participants (control group). Participants were assessed for the presence of chronic pain, pain location, intensity and catastrophizing, pain-related fear (kinesiophobia), anxiety and depression, physical activity, and sleep duration. The COPD group also completed assessments of dyspnea, exercise tolerance (6-minute walk distance [6MWD]), and activities of daily living (ADL).ResultsThe prevalence of pain was higher in the COPD group (85% vs 51%, p<0.001). The COPD group reported pain located in neck/shoulder, upper back, thorax and upper limbs, while the control group had more pain in the lower back. Pain catastrophizing and kinesiophobia were reported by 28% and 67% vs 9% and 42%, in the COPD and control groups respectively (both p<0.05). People with COPD and pain (n=58) reported greater dyspnea (p<0.001), and impairment in ADL (p<0.05), and lower 6MWD and physical activity (both p<0.01) compared to COPD participants without pain (n=10).ConclusionThis study demonstrated that, compared to community-dwelling participants, there is a higher prevalence of chronic pain in people with COPD. Pain combined with dyspnea may impact adversely on cognitive function and lead to anxiety and depression, as well as greater impairment in exercise tolerance, physical activity, and ADL. These results suggested that it is necessary to assess the symptoms of chronic pain and inflect in chronic pain coping strategies.

The effect of chronic pain on voluntary and involuntary capture of attention: An event-related potential study.

Although the interrupting effect of chronic pain on voluntary-directed attention is well-documented, research on the impact of chronic pain on involuntary-directed attention remains incomplete. This study aimed to investigate the influence of chronic pain on involuntary as well as voluntary allocation of attention as, respectively, indexed by the P3a and P3b components in the event-related potential derived from the electroencephalogram. Both involuntary and voluntary captures of attention were compared between 33 patients with chronic pain and 33 healthy controls using an auditory three-stimulus oddball task (with standard, target, and unexpected distractor tones). The results revealed a reduced P3a amplitude as well as a reduced P3b amplitude in patients with chronic pain compared to healthy controls, indicating a detrimental effect of chronic pain on involuntary and voluntary attention, respectively. This study extends the picture of the impairing effects of chronic pain on attentional allocation to a current task and attentional allocation to information outside the focus of attention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exercise Improves the Impact of Chronic Pain in Older Adults: Results of an RCT

Background: Chronic Pain (CP) is a crucial determinant for disability in older adults. CP amplifies the impact of other common age-related diseases and increases cardiovascular risk. Physical exercise can improve CP. Randomized Controlled Trials (RCTs) with high-intensity exercise in older adults excluded people with Moderate Chronic Illness (MCI) and CP. Objective: This study aimed at evaluating in an RCT whether moderate exercise training can improve chronic pain in a sample of older adults, including people with MCI, and if any modification persists over time. Methods: A sample of 120 older adults was randomly selected for a moderate-intensity exercise program or cultural activities (control group). Chronic pain was assessed at t0, at t12 (end of the trial), and t48 weeks, by means of the Italian version of the SIP-Roland Scale. Results: Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). At the end of RCT, an improvement in the SIP scale score was found in the exercise group (p=0.035), showing a lower score than the control group; this difference was not maintained at 48 weeks (p=0.235). Conclusion: Our study highlighted that a moderate-intensity exercise intervention reduced chronic pain in older adults, but this effect disappeared at follow-up after 36 weeks from the end of the training program. These findings suggested that such kinds of programs, easily accessible to old people even with MCI, should be implemented and supported over time, thus promoting active aging and preventing CP of age-related diseases. Clinical Trial Registration: Clinical.Trials.gov.NCT03858114

Impact of Work-Related Chronic Low Back Pain on Functional Performance and Physical Capabilities in Women and Men: A Sex-Wise Comparative Study.

Purpose This study is aimed at determining the impact of work-related low back pain (LBP) on functional performance and physical capabilities. Methods This cross-sectional study included women (n = 25, mean age, 38.12 ± 4.59) and men (n = 25, mean age, 37.20 ± 5.38) with a history of work-related mechanical chronic LBP who visited our university hospital's outpatient department. All participants were assessed for primary outcomes, including the severity of LBP on rest and on activity, functional performance, and physical capabilities using a numeric pain rating scale (NPRS), Roland-Morris disability questionnaire (RDQ), five-time sit-to-stand test (FTSST), and fifty-foot walk test (FFWT), respectively. Independent t-tests compared the scores of the outcomes between groups while Pearson's correlation coefficient identified the correlation between the outcomes' measures at a significance level of 0.05. Results With a response rate of 63.29%, a total of fifty participant's data were obtained for the analysis. A comparison between women and men groups highlighted a significant difference in the scores of the FTSST and FFWT; however, there were insignificant differences in the scores of the NPRS at rest, NPRS on activity, and RDQ. The bivariate correlation revealed a highly significant, positive, and moderate correlation between the scores of NPRS at rest and FTSST, NPRS on activity and FTSST, NPRS at rest and FFWT, NPRS on activity and FFWT, FTSST and RDQ, and FFWT and RDQ in the women group. Similarly, there was a significant, positive, and low correlation between the scores of FTSST and RDQ and FFWT and RDQ in the men group. Conclusion Work-related chronic LBP affected the physical capabilities of women more than those of men. However, it equally affected the functional performance of all participants in the study. Furthermore, work-related chronic LBP affected the physical capabilities (FTSST and FFWT) and functional performance (RDQ) of women more than those of men.

Management of chronic low back pain and the impact on patients' personal and professional lives: Results from an international patient survey.

ObjectiveThe objective of this study was to investigate the impact of chronic low back pain (CLBP) on patients’ personal and professional lives, and management strategies applied to treat CLBP.MethodsA 60‐question survey was developed, and respondents from 16 countries with a self‐reported physician's diagnosis of CLBP were recruited via an online market research survey panel. Respondents were stratified as having mild, moderate, or severe pain. Target sample sizes per country and for pain severity were set. Data were weighted according to the known population and prevalence of CLBP in each country and the number of respondents from that country.ResultsResults from 9642 CLBP patients indicated that almost a quarter of patients with severe CLBP report a psychological comorbidity. Prescription pain medications were more commonly used by patients with severe CLBP (56%) than those with mild (20%) or moderate (34%) CLBP. Among those with severe CLBP who had been prescribed pain medication, 58% were prescribed opioids, with 1 in 4 patients using opioids for more than 5 years. Patients were primarily managed by general practitioners/primary care physicians, physiotherapists, neurologists, or orthopedic surgeons. CLBP negatively impacted patients’ daily activities, social lives, and work productivity.ConclusionChronic low back pain has pronounced effects on patients’ personal relationships, ability to work, and daily living. Almost 1 in four patients with severe CLBP reported a psychological comorbidity. Adherence to guidelines appears inconsistent, which is noteworthy as a substantial subgroup of patients with severe CLBP had been prescribed opioid medication for more than 5 years. Improved education is required to support healthcare professionals (HCPs) in identifying and understanding the complex biopsychosocial needs of CLBP patients to optimize pain management and to encourage referral of CLBP patients to physiotherapists and psychologists.

Prevalence of and factors associated with long-term sick leave in working-age adults with chronic low back pain in Germany.

There are little data on the impact of chronic low back pain (CLBP) on long-term sick leave. Thus, the aim was to investigate the prevalence of and the factors associated with long-term sick leave in working-age adults with CLBP in Germany. This retrospective study included adults aged 18-65years diagnosed for the first time with CLBP in one of 1193 general practices in Germany between 2000 and 2019. CLBP was defined as the presence of two diagnoses of low back pain with > 90days between them. Long-term sick leave was assessed in the year following the first diagnosis of low back pain, and was defined as > 42days of absence from work for health-related reasons. In Germany, employees on sick leave lasting > 42days are not paid by the employer anymore but by the health insurance fund. Finally, an adjusted logistic regression model was used to assess the association between predefined variables (e.g., age, sex, and comorbidities) and long-term sick leave. A total of 59,269 working-age adults were included in this study [mean (SD) age 32.8 (11.5) years; 41.4% women]. The prevalence of long-term sick leave in the sample was 49.1%. Long-term sick leave was significantly associated with young age, male sex, and several physical and psychiatric comorbidities (e.g., reaction to severe stress and adjustment disorder, gastritis and duodenitis, and depression). Based on these results, public health measures are urgently needed to mitigate the deleterious effects of CLBP on work participation in Germany.

The Effect of M-Health-Based Core Stability Exercise Combined with Self-Compassion Training for Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study.

IntroductionNonspecific chronic low back pain (NCLBP) is a leading contributor to disease burden worldwide, and the management of NCLBP has always been a problem. This study is designed to explore the feasibility and efficacy of m-health-based core stability exercise (CSE) combined with self-compassion training (SCT) and compare it with m-health-based CSE alone for the management of NCLBP.MethodsThis study is a pilot, patient-blinded randomized controlled trial. Participants with NCLBP were randomized into an intervention group and a control group. All the participants received m-health-based CSE, but those in the intervention group also received SCT before CSE. The intervention took place weekly on Saturday or Sunday for 4 weeks in total. Patients self-assessed their outcomes by filling out electronic questionnaires at 4 and 16 weeks after the start of the study. The primary outcome metrics for these questionnaires were back pain disability (based on the Roland–Morris Disability Questionnaire, RMDQ) and Pain intensity (Numeric Rating Scale, NRS; current pain, worst pain, average pain). The secondary outcome metrics were anxiety (GAD-7,7-item Generalized Anxiety Disorder scale), Depression Symptoms (PHQ-9,Patient Health Questionnaire-9), pain catastrophizing (PCS, Pain Catastrophizing Scale) and Self-efficiency (PSEQ, Pain Self-Efficiency Questionnaire).ResultsA total of 37 patients comprising 28 (75.7%) females completed the study, with 19 patients in the intervention group and 18 in the control group. The mean (SD) patient age was 35.2 (11.1) years. For all primary outcomes, although there were no significant differences between groups, we found that participants in the intervention group improved function and pain earlier. The RMDQ score changed by − 1.771 points (95% CI − 3.768 to 0.227) from baseline to 4 weeks in the control group and by − 4.822 points (95% CI − 6.752 to − 2.892) in the intervention group (difference between groups, − 3.052 [95% CI − 5.836 to − 0.267]). Also, the RMDQ score changed by − 3.328 points (95% CI − 5.252 to − 1.403) from baseline to 16 weeks in the control group and by − 5.124 points (95% CI − 7.014 to − 3.233) in the intervention group (difference between groups − 1.796 [95% CI − 4.501 to 0.909]). A similar pattern was found in the NRS scores. For secondary outcomes, the intervention group was superior to the control group in for GAD-7 (intervention difference from CSE along at week 16, − 2.156 [95% CI − 4.434 to − 0.122; P value for group effect was 0.030]). At the end of treatment, the improvement in PCS in the intervention group was significant (difference in PCS score at week 4, − 6.718 [95% CI − 11.872 to − 1.564]). We also found significant changes in PCS in the control group (− 6.326 [95% CI, − 11.250 to − 1.401]) at the 16-week follow-up. As for PSEQ, there were no apparent differences between the two groups. There were no adverse events relented to study participation.ConclusionsThe pilot study is feasible to deliver, and our results indicate that participants in the group of m-health-based CSE combined with SCT may experience faster relief from pain intensity and back disability than those in the group of m-health-based CSE alone.Trial RegistrationChiCTR2100042810.

Development and Validation of a Scale for Assessing the Interference of Chronic Primary Pain Conditions in Sexual Functioning: The Sex-Pain Questionnaire

Chronic pain represents one of the main health public problems worldwide and significantly affects the sexual life of patients. However, no specific instruments of evaluation have been found that address this population. This study presents the SEX-PAIN Questionnaire, developed for identifying chronic pain’s interference with sexual functioning among people with chronic pain. Methods. The validation has been carried out with a sample of 303 Spanish non-hospitalized patients with chronic pain diagnosis aged between 20 and 71 years old (Mage = 49.49; SD = 10.7). Exploratory Factor Analysis (EFA) yielded 2-factor structure: Sexual and Relationship Dissatisfaction, and Chronic Pain Impact on Sexual Life. This structure was later verified through Confirmatory Factor Analysis (CFA). Internal consistency (Omega) of each factor was .72 and .96, respectively. This study presents the psychometric properties of a new measure addressed to patients with chronic pain. This 17-items self-administered instrument can be a useful measure of the chronic pain’s interference with sexual functioning among chronic pain patients. It represents the first original questionnaire known in Spanish language to date. This measure could potentially help researchers and clinicians to obtain key information to design appropriate healthcare interventions. Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2039336 .

Psychological morbidity following spinal cord injury and among those without spinal cord injury: the impact of chronic centralized and neuropathic pain.

Study Design:Longitudinal cohort study of privately-insured beneficiaries with and without traumatic spinal cord injury (SCI).Objectives:Compare the incidence of and adjusted hazards for psychological morbidities among adults with and without traumatic SCI, and examine the effect of chronic centralized and neuropathic pain on outcomes.Setting:Privately-insured beneficiaries were included if they had an ICD-9-CM diagnostic code for traumatic SCI (n=9,081). Adults without SCI were also included (n=1,474,232).Methods:Incidence of common psychological morbidities were compared at 5-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident psychological morbidities.Results:Adults with SCI had a higher incidence of any psychological morbidity (59.1% vs. 30.9%) as compared to adults without SCI, and differences were to a clinically meaningful extent. Survival models demonstrated that adults with SCI had a greater hazard for any psychological morbidity (HR: 1.67; 95%CI: 1.61, 1.74), and all but one psychological disorder (impulse control disorders), and ranged from HR: 1.31 (1.24, 1.39) for insomnia to HR: 2.10 (1.77, 2.49) for post-traumatic stress disorder. Centralized and neuropathic pain was associated with all psychological disorders, and ranged from HR: 1.31 (1.23, 1.39) for dementia to HR: 3.83 (3.10, 3.68) for anxiety.Conclusions:Adults with SCI have a higher incidence of and risk for common psychological morbidities, as compared to adults without SCI. Efforts are needed to facilitate the development of early interventions to reduce risk of chronic centralized and neuropathic pain and psychological morbidity onset/progression in this higher risk population.

Foundational Research Could Improve Future Transcutaneous Electrical Nerve Stimulation Evaluations.

Background and objectives: There is a lack of good quality evidence regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for chronic musculoskeletal pain, including chronic low back pain. High quality randomised controlled trials (RCTs) have been called for to establish effectiveness over and above placebo and some guidance has already been offered regarding the design of such trials. This article expands the discussion regarding the design of future TENS trials. There is qualitative evidence of the complexity of TENS as an intervention which should be considered in future TENS evaluations. This complexity includes multiple benefits reported by patients, depending on their chosen contexts of TENS use. The ideal content and delivery of support for patients to optimise TENS use also lacks consensus. There is no evidence that a TENS education package has been designed to support the complex set of behaviours and choices which experienced users suggest are required to optimise TENS benefits. Finally, clinical and research outcomes have not been contextualised and related to the specific strategies of use. Conclusions: We suggest that research is required to develop consensus about the content and delivery of training in TENS use for patients who live with pain, informed by the experience of patients, clinicians, and researchers. Once a consensus about the content of TENS training has been reached, there is then a need to develop a TENS training course (TTC) based on this content. An effective and acceptable TTC is needed to develop the knowledge and skills required to optimise TENS use, supporting patients to build confidence in using TENS in everyday life situations with the aim of reducing the impact of chronic pain on function and quality of life. Further research is required to extend the evidence base regarding appropriate, contextualised TENS patient-reported outcomes.

The Critical Role of Nutrition Care to Improve Pain Management: A Global Call to Action for Physical Therapist Practice.

The nutrition care process for pain management is defined as the basic duty to provide adequate and appropriate nutrition education and counseling to people living with pain. Including the nutrition care process as part of a multimodal approach to pain management provides an opportunity for physical therapists to assert their role throughout the pain management continuum. This includes championing innovative research initiatives and enhancing public health by reducing the impact of chronic pain for over 50 million Americans.

Living with osteogenesis imperfecta: A qualitative study exploring experiences and psychosocial impact from the perspective of patients, parents and professionals.

Osteogenesis imperfecta (OI) is a rare genetic condition characterised by increased bone fragility. Recurrent fractures, pain and fatigue have a considerable impact on many aspects of the life of a person affected with OI and their families. To improve our understanding of the impact of OI on the daily lives of individuals and families and consider how the condition is managed so that support needs can be better addressed. Semi-structured qualitative interviews (n=56) were conducted with adults affected with OI, with (n=9) and without children (n=8), parents of children affected with OI (n=8), health professionals (n=29) and patient advocates (n=2). Interviews were digitally recorded, transcribed verbatim and analysed using thematic analysis. Three overarching themes are described: OI is not just a physical condition, parenting and family functioning and managing the condition. Fractures, chronic pain and tiredness impact on daily life and emotional well-being. For parents with OI, pain, tiredness and mobility issues can limit interactions and activities with their children. Specialist paediatric health services for OI were highly valued. The need for more emotional support and improved coordination of adult health services was highlighted. Our findings allow a better understanding of the day-to-day experiences of individuals and families affected with OI. Supporting emotional well-being needs greater attention from policy makers and researchers. Improvements to the coordination of health services for adults with OI are needed and an in-depth exploration of young people's support needs is warranted with research focused on support through the teenage years.

Perceived Stress and Life Stressors in Adults With and Without Fibromyalgia

Population aging will inevitably bring an increasing burden of poor cognitive function. The risk factors for cognitive decline have been widely studied. Even though environmental hazards have the greatest adverse impacts on older adults and the existing evidence has shown that green space, air pollution, and weather have an impact on cognitive function, most of the studies were conducted in developed countries and limited to cross-sectional analyses. China has the largest aging population in the world so the research evidence from it can offer an insight to the study in other developing countries facing similar issues and inform future public health policy and disease control. Using the data from a nationally representative sample of adults aged 45 years and older from the three waves of China Health and Retirement Longitudinal Study (CHARLS 2011-2015) and China City Statistical Yearbook, this study estimated multilevel growth curve models for the effects of green space coverage, air pollution, and weather conditions on cognitive function and cognitive decline. It showed that after controlling for sociodemographic characteristics, built area green coverage rate was positively associated with cognition score at baseline, and higher annual minimum temperature was associated with faster decline in cognitive function. These effects did not substantially change after weekly total hours of physical activities and levels of social engagement were added and the interaction effects were examined between environmental conditions with them, respectively. More research on the mechanisms of the effects of environmental factors on cognition is needed such as the subgroup analyses.

Effects of Weight and Pain on Physical Activity: Insights from the Lived Experiences of Youth with Co-Occurring Chronic Pain and Obesity.

Objective: Pediatric obesity and chronic pain are each associated with an increased risk for numerous poor physical and mental health outcomes. Co-occurring chronic pain and obesity (CPO) result in greater functional disability compared with either condition alone. The aim of the present study was to use qualitative methods to better understand the challenges experienced by adolescents with CPO, with a specific focus on physical activity. Methods: Semistructured interviews were conducted with 13 youth with CPO. Participants were questioned about pain, physical activity, coping strategies, and the perceived relationship between weight and pain. Interviews were audiorecorded, transcribed, and analyzed according to Interpretative Phenomenological Analysis. Results: Superordinate themes expressed by youth included: Impact of Chronic Pain on Relationships, Impact of Pain on Self-Perception, Using Food to Cope with Pain, Perceived Relationship between Pain and Weight after Onset of Pain, Attitudes toward Physical Activity, Barriers to Physical Activity, and Supports to Physical Activity. Conclusions: Participants identified challenges associated with CPO. Notably, participants identified pain as a greater barrier to exercise than weight, implicating the salience of chronic pain in the lives of youth with CPO. Furthermore, participants identified a desire to be more physically active, yet discussed struggles and concerns about attempts to increase their physical activity and indicated a desire for guidance about being more active. This study highlights the complexities of the relationship between CPO and underscores the importance of providers collaboratively working with patients to develop a practical plan to resume movement and physical activity.

The prevalence of chronic pain in young adults: a systematic review and meta-analysis.

Previous systematic reviews have summarized the prevalence and impact of chronic pain in "average" pediatric (ie, school-age children) and adult (ie, middle-aged individuals) age groups. To the best of our knowledge, this is the first study to describe the prevalence of chronic pain in the subgroup of individuals who fall in between established boundaries of "childhood" and "adulthood"-known as young adulthood. The goal of this research was to meta-analyze prevalence data on pain in young adults based on available data published between 2008 and 2020. Searches were identified with MEDLINE, Embase, and PsycINFO. We included general population and university-based studies presenting prevalence estimates of chronic pain (pain lasting ≥3 months) in young adults. We identified 43 articles providing prevalence estimates across a combined population of 97,437 young adult respondents (age range: 15-34 years), with studies undertaken in 22 countries. Available data allowed for stratification of prevalence according to pain condition. The overall pooled random-effect prevalence rate of chronic pain in young adults was 11.6%, suggesting that 1 in every 9 young adults experience chronic pain worldwide. Prevalence rates varied considerably according to pain condition. Estimates did not vary according to sex, geographic location, and several study methodological characteristics (ie, population type, sampling area, sampling year, investigation period, and assessment method). Overall, young adult chronic pain is common and should be recognized as a major public health concern. Considering the difficulties young adults face accessing adult health care, greater attention is needed to develop transition programs and evidence-based treatments tailored to the unique needs of this age group.

Chronic Pain Assessment in Moroccan Hemodialysis Population

Introduction: This study aims to assess the prevalence, as well as the impact of chronic pain on the daily life of hemodialysis patients and to determine the associated socio-demographic, clinical-biological, and psychological factors. Methods: This study was a cross-sectional study that included 441 hemodialysis patients. The characteristics of the chronic pain were collected by the Brief Pain Inventory questionnaire and by the visual analog scale. The anxious and depressed mood was assessed by the Hospital Anxiety and Depression Scale, factors associated with chronic pain were determined through univariate and multivariate analysis. Results: the prevalence of chronic pain was 72.8%. It was severe in 40.8% of cases and it completely interfered with general activity in 72.9% of cases. The most frequently reported pain site was: lowers extremities (39.9%). Thus, 59.9% of patients reported using analgesics, with a frequent intake in 74.3% of cases. Anxiety and depression were found respectively in 68% and 66% of cases. The chronic pain was significantly associated with depression (p<0.001), anxiety (p<0.001), living conditions (p<0.001), level of studies (p<0.001), and marital status (p=0.020). Conclusion: A multidisciplinary approach is recommended for the management of chronic pain, involves Nurses, physiotherapists, psychologists, health educators and family.

Cognitive Reserve as a Protective Factor of Mental Health in Middle-Aged Adults Affected by Chronic Pain.

Chronic pain is associated with worse mental health and cognitive impairment, which can be a cause or a consequence of brain structure and function alterations, e.g., maladaptive plasticity, antinociceptive system dysregulation. Cognitive reserve reflects the effectiveness of the internal connections of the brain and it has been shown to be a protective factor in brain damage, slowing cognitive aging or reducing the risk of mental health disorders. The current study explored the impact of chronic pain on psychosocial factors, mental health, and cognition. Furthermore, we aimed to examine the role of cognitive reserve in the relationship between mental health and chronic pain clinical characteristics in middle-aged adults. The study group consisted of 477 volunteers from the Barcelona Brain Health Initiative who completed online surveys on pain, mental health, cognitive reserve, and psychosocial factors (sleep and quality of life). We described the differences in sociodemographic data, psychosocial factors, mental health, and self-perceived cognitive impairment, and neuropsychological assessment, between participants reporting pain compared with those without pain, as well as the main characteristics of the chronic pain group. Finally, to study the role of cognitive reserve in the modulation of the relationship between chronic pain and mental health, we compared variables between subgroups of participants with high/low pain intensity and cognitive reserve. The results showed that chronic pain was reported by 45.5% of middle-aged adults. Our results revealed that participants with chronic pain were older and had worse health status than people without pain. The presence of chronic pain affected working memory, mental health, and daily life activities. Moreover, cognitive reserve moderated the influence of pain intensity on mental health, resulting in less mental health affection in people suffering from high pain intensity with high cognitive reserve. In conclusion, the construct of the cognitive reserve could explain differential susceptibility between chronic pain and its mental health association and be a powerful tool in chronic pain assessment and treatment, principally due to its modifiable nature.

The Impact of Chronic Neck Pain on Respiratory Functions among Female University Students

Objective: Students with chronic neck pain have several issues that could constitute susceptibility to respiratory dysfunction. So, this current study was conducted to investigate the impact of chronic neck pain on respiratory function among female university students.Material and Methods: In this cross-sectional study, 60, female University students voluntarily participated, and were divided into two groups: 30 students with chronic idiopathic neck pain (age=21.9±2.2 years, height=160.7±6.5 cm, weight=71.9±8.5 kg, body mass index (BMI)=28±3.6 kg/cm2 ), and 30 healthy students as the control group (age=21.5±2.1 years, height=163.5±6.8 cm, weight=69.5±11 kg, BMI=26.2±5 kg/cm2 ). Both groups were investigated using a Spirometer (One-FlowTM Forced Vital Capacity (FVC) Kit, USA, Granbury). Descriptive statistics and Multivariate analysis of the variance test were both used to compare both groups.Results: Students with chronic neck pain were found to have statistically significant reductions in Peak Expiratory Flow and the Forced Expiratory Volume in one second (FEV1)/FVC ratio (p-values=0.043 and 0.000, respectively). However, FVC (p-value=0.372) and FEV1 (p-value=0.840) revealed no statistically significant differences between both groups.Conclusion: Respiratory dysfunction, with chronic neck pain mainly manifests as respiratory weakness and hypocapnia. Studying the hypothesis of neck pain, and its possibility of causing respiratory dysfunction in these subjects gives rise to important clinical implications concerning the assessment and treatment of patients with chronic neck pain.