Prevalence Of Chronic Pain Research Articles

Endometriosis, chronic pain, anxiety, and depression: A retrospective study among 12 million women

BackgroundThere is a lack of information regarding the impact of the physical symptoms associated with endometriosis and chronic pain on the mental health and well-being of affected women. Thus, our study aimed to evaluate the relationship between endometriosis, chronic pain, anxiety, and depression. ObjectiveOur study aimed to evaluate the relationship between endometriosis, chronic pain, and mental health disorders among women registered in a large database until 2014. Study designThis was a retrospective population-based study involving 12,904,324 hospitalized women from the Healthcare Cost and Utilization Project (HCUP) database between 2007 and 2014. We calculated the prevalence of chronic pain, endometriosis, anxiety, and depression during the study period. We used multivariate logistic regression to examine the relationship between these variables. ResultsAn upward pattern was noted in the prevalence of chronic pain, while an opposite trend was seen for endometriosis during the study period. After adjusting for sociodemographic characteristics and comorbidities, including depression, the highest odds ratio of experiencing anxiety appeared in the group with both chronic pain and endometriosis (OR = 2.719, 95 % CI 2.481–2.979). LimitationsHCUP is a cross-sectional administrative database that does not link patients' records over the years. Thus, we could not establish any temporal association between endometriosis, chronic pain, anxiety, and depression. ConclusionPotential associations were identified between endometriosis, with and without chronic pain, anxiety, and depression. We recommended that clinicians provide proper medical management of endometriosis-related pain through symptom management and adequate counseling for those suffering from anxiety and depression.

Treated versus self-reported prevalence of chronic pain and costs of patients' health services utilization: a population-based study of health administrative databases.

To compare treated to self-reported prevalence of chronic pain (CP) and to estimate health services utilization (HSU) costs of patients treated for CP in Alberta, Canada. Patients treated for CP were identified by the physician billing codes of health services for CP from the practitioner claims database in fiscal year 2021/22. The treated prevalence of CP (number of these patients divided by the population) was compared to the self-reported prevalence of CP previously estimated (doi:10.1371/journal.pone.0272638). Costs of patients' HSU included costs for general practitioner (GP), specialist, inpatient, emergency department, outpatient clinic services, and prescription drugs. The treated prevalence of CP was 6.0% (4.4% among males and 7.8% among females) which was 30% to 41% of the self-reported prevalence. The highest treated prevalence (7.2%) was found in the age group of 18-64years, followed by age groups of >64years (7.0%) and <18years (2.1%). The average cost per patient per year was $5096 ($5878 for males and $4652 for females), of which hospitalizations accounted for 65.0%, outpatient clinic visits 16.4%, ED visits 9.5%, prescription drugs 4.7%, GP visits 3.9%, and specialist visits 0.4%. The total cost of patients with CP for the health system was $1.37 billion (∼7% of total health expenditure), of which males accounted for 41.7% and females for 58.3%. Our findings suggest that the economic burden of CP is considerable and that many people with self-reported CP do not use the public healthcare services. This can be multifactorial, including lack of availability and accessibility of publicly funded services, people's lack of awareness of available services, lower utilization due to COVID-19 pandemic, and reliance on self-management, private services, and alternative treatments. Further studies are warranted to inform future policies and health system initiatives aiming to reduce the burden of CP and improve lives of people living with it.

Evaluation of surgical complications after herniated spinal lumbar disc surgery

ObjectiveOne of the important and common complications of spinal surgery is Failed Back Surgery Syndrome (FBSS). The most significant symptom of this syndrome is prolonged pain after the surgery, which comes with many complications.Due to the importance of chronic pain after spinal surgeries and its complications, we have decided to investigate the prevalence of acute and chronic pain and other consequences after lumbar disc herniation surgery. MethodsIn this descriptive retrospective cohort study, 236 patients were selected using the available sampling method. Then, these patients were evaluated for complications such as worsening pain, the need for repeat surgery, mortality rate, and the level of symptom improvement.The checklist includes demographic information about the patient and information during and after surgery, which can be extracted from the patient's medical record. Additionally, the patient's preoperative pain severity and the occurrence and severity of acute and chronic pain after surgery, sensory and motor disability after surgery, and the need for repeat surgery are extracted through telephone contact with the patient, using the VAS scale as a criterion. ResultsIn this study, out of 236 patients who underwent discectomy surgery, 115 female patients (48.7 %) and 121 male patients (51.3 %). The mean age of this study was 51.81 years, with the minimum age being 36 and the maximum age being 60 years.70 patients (66.29%), experienced postoperative complications in this study. Of these, 15 patients (3.6%) experienced only acute pain, 16 patients (7.6%) experienced only chronic pain, and 39 patients (5.16%) experienced both acute and chronic pain. In addition, 42 patients (8.17%) experienced sensory-motor deficits after the operation, and 24 patients (2.10%) required further surgery after the first operation. ConclusionAge and smoking are among the influential factors in the surgical outcome for the patient. In addition, a history of underlying disease, especially diabetes, can have an impact on the occurrence of pain and sensory-motor disability after the operation. Among the effective therapeutic factors in the surgical outcome, the length of surgery and the use of postoperative narcotics can be mentioned. Additionally, the type of surgical technique and anesthesia can also be influential factors in the surgery, which require further study with a larger population and a variety of surgical techniques and anesthesia.

Self-reported chronic pain: Prevalence and characteristics in the Capital Region of Denmark

Abstract Background Chronic pain is a burden for both the individual and the society. Primary chronic pain has been included in the International Classification of Disease, 11th version (ICD-11), defined as persistent or recurrent pain for more than three months. The aim of the study was to estimate the prevalence of self-reported chronic pain approximating this definition as well as characteristics of persons with self-reported chronic pain in the Capital Region of Denmark, comprising 1/3 of the citizens in Denmark. Methods Self-reported chronic pain, defined to approximate the ICD-11 definition, was assessed in the Danish Capital Region Health Survey 2021, including 56,245 participants from the general population aged ≥16 years (response rate 54.9%). The question was validated using cognitive interviewing. Characteristics of persons with chronic pain were assessed using national registries (socio-demographics) as well as questionnaire data (health status and health-related behavior). Descriptive analyses and multivariate logistic regression models weighted for survey design and non-response were performed. Results Preliminary results show that 32% in the Capital Region of Denmark in 2021 had self-reported chronic pain. More women (35%) than men (28%) reported chronic pain. The prevalence of chronic pain increased with age, but still, 20 % of persons aged 16-34 years also reported chronic pain. Chronic pain was inversely associated with education; thus, 45% of persons with short education reported chronic pain. Associations between chronic pain and mental and physical health status as well as health-related behavior, pain interference and pain location will be presented. Conclusions Self-reported chronic pain is highly prevalent in the general adult population of the Capital Region of Denmark. Knowledge on prevalence and characteristics of persons with chronic pain is important to create effective prevention and treatment strategies. Key messages • Chronic pain is highly prevalent in the general population. • More focus and research are needed on chronic pain – both concerning prevention and treatment.

Physician perspectives on chronic pain management: barriers and the use of eHealth in the COVID-19 era

BackgroundChronic pain is a highly prevalent and disabling condition which is often undertreated and poorly managed in the community. The emergence of COVID-19 has further complicated pain care, with an increased prevalence of chronic pain and mental health comorbidities, and burnout among physicians. While the pandemic has led to a dramatic increase in virtual health care visits, the uptake of a broader range of eHealth technologies remains unclear. The present study sought to better understand physicians’ current needs and barriers in providing effective pain care within the context of COVID-19, as well as gauge current use, interest, and ongoing barriers to eHealth implementation.MethodsA total of 100 practicing physicians in British Columbia, Canada, completed a brief online survey.ResultsThe sample was comprised of physicians practicing in rural and urban areas (rural = 48%, urban = 42%; both = 10%), with the majority (72%) working in family practice. The most prominent perceived barriers to providing chronic pain care were a lack of interdisciplinary treatment and allied health care for patients, challenges related to opioid prescribing and management, and a lack of time to manage the complexities of chronic pain. Moreover, despite expressing considerable interest in eHealth for chronic pain management (82%), low adoption rates were observed for several technologies. Specifically, only a small percentage of the sample reported using eHealth for the collection of intake data (21%), patient-reported outcomes (14%), and remote patient monitoring (26%). The most common perceived barriers to implementation were cost, complexity, and unfamiliarity with available options.ConclusionsFindings provide insight into physicians’ ongoing needs and barriers in providing effective pain management during the COVID-19 pandemic. Despite the potential for eHealth technologies to help address barriers in pain care, and strong interest from physicians, enhanced useability, education and training, and funding are likely required to achieve successful implementation of a broader range of eHealth technologies in the future.

Prevalence and determinants of chronic pain and persistent opioid use after surgery: A review of systematic reviews.

Chronic post-surgical pain (CPSP) and persistent post-operative opioid use (PPOU) are inconsistently defined in published literature. This review comprehensively summarised their definitions, prevalence and determinants from existing systematic reviews or meta-analyses. Systematic reviews or meta-analyses evaluating the prevalence of CPSP and PPOU in adults after surgeries were retrieved from an electronic database search applying structured search strategies in PubMed, MEDLINE, Embase, CINAHL Plus and Cochrane Database of Systematic Reviews from inception to 31 December 2022. Two reviewers selected systematic reviews, extracted data regarding the definition, prevalence and risk factors of CPSP and PPOU and assessed the quality using the AMSTAR 2 tool. The study identified 6936 records related to chronic pain and persistent opioid use in patients after surgery, of which 24 articles were identified for full-text review. Eighteen systematic reviews were included in this umbrella review, of which five systematic reviews assessed chronic pain in patients who had undergone a surgical procedure, and 13 reviews assessed persistent opioid use after surgery. Despite considerable variations in patient characteristics (from age ≥18years), types of surgeries, follow-up duration and the definitions of measures, most reviews were of medium to good quality (fulfilled 9-11/16 AMSTAR 2 criteria). The prevalence of CPSP and PPOU, commonly synthesised at 3, 6 or 12months after surgeries, varied from 5%-58% and 2%-65%, respectively, despite various terminologies, definitions and timing of measures and associated determinants. The prevalence of neuropathic pain in CPSP was obtainable for four surgeries, with 9%-74%. To inform future practice and policy to optimise pain management and opioid safety, consensus on standardising measurements and further studies assessing risk factors associated with CPSP, PPOU and adverse outcomes are needed.

Behavioral physical activity intervention coupled with standard post-cancer directed treatment care to mitigate chronic pain in childhood cancer survivors: A protocol for a single-center, pilot randomized controlled trial

BackgroundLong term survivors of childhood cancer have a high prevalence of chronic pain. Novel, multidisciplinary approaches to manage pain, are needed to allow for a reduction in the use of opioids for pain management. Physical activity is highly effective in managing chronic pain in children and adolescents, however, evidence about the combination of physical activity intervention and pain medications in chronic pain management in childhood cancer survivors is lacking. The aim of this study is to investigate the feasibility, acceptability and preliminary effects of a behavioral physical activity intervention integrated into standard post cancer directed treatment care to mitigate chronic pain in this unique population. MethodsThis is a single site pilot randomized controlled trial of a 16-week physical activity intervention coupled with standard care. The primary aim is to assess the feasibility and acceptability of the physical activity intervention in childhood cancer survivors with chronic pain. Secondary aims include evaluating the differences in functional and psychosocial outcomes along with self-reported pain scores and cumulative dose of pain medications between the exercise group and standard cancer care group. The physical activity intervention is a home-based program structured to increase patients' physical activity behavior and to favor low intensity bodily movement using aerobic exercise and resistance training. ConclusionsThis study will demonstrate that behavioral supportive measures like physical activity may be a novel means to improve cancer related chronic pain in young survivors of childhood cancer and decrease medication usage for pain along with improvement in functional and psychosocial outcomes.

Prevalence of Chronic Backpain after COVID-19 Astra Zeneca and Pfizer/BioNTech Vaccines in Sultanate of Oman: A Survey-based Study

Introduction: Covid-19 vaccine is known to cause a variety of side effects. Low back pain has been reported to be associated with at least one of the COVID-19 vaccines. Objectives: The current study investigated the prevalence of chronic back pain in individuals vaccinated with AstraZeneca and Pfizer in Sultanate of Oman. Methods: This cross-sectional observational survey-based study was conducted among COVID-19 AstraZeneca and Pfizer/BioNTech vaccinated individuals in Sultanate of Oman. Two hundred participants were involved in the study. Chi square was used to analyse the association between categorical data. Data were analysed using SPSS (29th release). Results: The prevalence of back pain among individuals vaccinated with AstraZeneca and Pfizer, was 36%. Females were more commonly affected by the back pain, especially in the 4th decade of life. Conclusion: AstraZeneca and Pfizer is be associated with back pain, especially in females. Possible explanations require further investigations.

Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities.

Co-occurrence of chronic pain and clinically significant symptoms of anxiety and/or depression is regularly noted in the literature. Yet, little is known empirically about population prevalence of co-occurring symptoms, nor whether people with co-occurring symptoms constitute a distinct subpopulation within US adults living with chronic pain or US adults living with anxiety and/or depression symptoms (A/D). To address this gap, this study analyzes data from the 2019 National Health Interview Survey, a representative annual survey of self-reported health status and treatment use in the United States (n = 31,997). Approximately 12 million US adults, or 4.9% of the adult population, have co-occurring chronic pain and A/D symptoms. Unremitted A/D symptoms co-occurred in 23.9% of US adults with chronic pain, compared with an A/D prevalence of 4.9% among those without chronic pain. Conversely, chronic pain co-occurred in the majority (55.6%) of US adults with unremitted A/D symptoms, compared with a chronic pain prevalence of 17.1% among those without A/D symptoms. The likelihood of experiencing functional limitations in daily life was highest among those experiencing co-occurring symptoms, compared with those experiencing chronic pain alone or A/D symptoms alone. Among those with co-occurring symptoms, 69.4% reported that work was limited due to a health problem, 43.7% reported difficulty doing errands alone, and 55.7% reported difficulty participating in social activities. These data point to the need for targeted investment in improving functional outcomes for the nearly 1 in 20 US adults living with co-occurring chronic pain and clinically significant A/D symptoms.

Prevalence and quality of temporomandibular disorders, chronic pain and psychological distress in patients with classical and hypermobile Ehlers-Danlos syndrome: an exploratory study

BackgroundThe Ehlers-Danlos syndromes are a group of clinically and genetically heterogeneous hereditary diseases affecting the connective tissue. They are characterized by hypermobility of the joints, hyperextensible skin and friable tissue. According to current classification, 13 subtypes can be distinguished, of which the hypermobile and the classical subtype are the most prevalent. This study aimed to evaluate patients with classical (cEDS) and hypermobile (hEDS) Ehlers-Danlos syndrome regarding temporomandibular disorder (TMD), chronic pain, and psychological distress.MethodsSupport groups from Germany, Austria, and Switzerland were contacted, and social media were used to recruit participants. Free text questions, the German version of the Depression Anxiety and Stress Scale (DASS), and the German version of the Graded Chronic Pain Status (GCPS) were used.Results259 participants were included (230 hEDS/29 cEDS). At least 49.2% of the participants had painful or restricted jaw movements, and at least 84.9% had pain in the masticatory muscles, with 46.3% already having a diagnosed TMD. Multivariate analysis showed a significant correlation between TMJ involvement and chronic pain with a 2.5-fold higher risk of chronic pain with a diagnosed TMD. 22.8% of participants had a critical score for depression, 53.3% had a critical score for anxiety, and 34.0% had a critical score for stress.ConclusionThere is a high prevalence of TMD problems and chronic pain in patients with cEDS and hEDS. The lack of knowledge about these problems can create psychological distress. More research is needed to provide adequate treatment for patients with EDS.

Sex-specific adipose tissue’s dynamic role in metabolic and inflammatory response following peripheral nerve injury

Epidemiological data and research highlight increased neuropathy and chronic pain prevalence among females, spanning metabolic and normometabolic contexts, including murine models. Prior findings demonstrated diverse immune and neuroimmune responses between genders in neuropathic pain (NeP), alongside distinct protein expression in sciatic nerves. This study unveils adipose tissue's (AT) role in sex-specific NeP responses after peripheral nerve injury. Metabolic assessments, metabolomics, energy expenditure evaluations, AT proteomic analyses, and adipokine mobilization depict distinct AT reactions to nerve damage. Females exhibit altered lipolysis, fatty acid oxidation, heightened energy expenditure, and augmented steroids secretion affecting glucose and insulin metabolism. Conversely, male neuropathy prompts glycolysis, reduced energy expenditure, and lowered unsaturated fatty acid levels. Males' AT promotes regenerative molecules, oxidative stress defense, and stimulates peroxisome proliferator-activated receptors (PPAR-γ) and adiponectin. This study underscores AT's pivotal role in regulating gender-specific inflammatory and metabolic responses to nerve injuries, shedding light on female NeP susceptibility determinants.

223 Chronic pain is frequently under-treated among older people in Ireland: data from TILDA

Abstract Background Chronic pain can have significant adverse effects on quality-of-life, functional status, and well-being in later life. Concerns exist regarding under-treatment of pain among older people, however. The aim of this study, therefore, is to ascertain the prevalence of chronic pain among older people in Ireland, including prescribed pharmacological treatment. Methods Participants ≥70 years at TILDA Wave 1 were asked ‘Are you often troubled with pain?’ and if yes, were then asked ‘How bad is it most of the time? Mild, moderate, or severe?’. Medication lists were examined by anatomical therapeutic chemical code for analgesics (N02), opioids (N02A), and non-opioid analgesics (N02B). Frailty was assessed by Fried Frailty Scale. Data was analysed descriptively. Chi-square tests assessed differences in binary variables; t-tests for continuous variables. Results Over 1/3 of participants (n = 2,308; mean 77 years; 53% female) reported chronic pain (839/2,308), with 10% (222/2,308) reporting severe pain. Over 60% of participants with chronic pain (517/839) reported pain made it difficult to complete day-to-day activities. Almost two thirds of participants with moderate–severe pain (407/618) were not prescribed analgesia. Participants with untreated chronic pain were more likely to be female (62% vs 52%, p &amp;lt; 0.001), have functional impairment (22% vs 13%, p &amp;lt; 0.001) and to be frail (14% vs 6%, p &amp;lt; 0.001). Over 98% of participants with untreated pain had contact with healthcare (GP practice or ED) in the preceding 12 months. Conclusion In this population-representative analysis, chronic pain affects 1/3 older people in Ireland, with 1/10 reporting severe pain. Chronic pain often limits day-to-day activities yet is frequently under-treated or not treated at all, particularly in frail, older females, despite contact with the healthcare service. It is imperative, therefore, that we empower older people to report chronic pain to a healthcare professional and we facilitate appropriate assessment and treatment of their pain.

Chronic pain: its impact on the quality of life and gender.

Chronic pain poses a considerable challenge to individuals' well-being, leading to decreased quality of life, limitations in daily functioning, and a higher reliance on healthcare services, resulting in significant economic burdens. In South Africa, chronic pain ranks among the prevalent chronic health conditions, although the exact prevalence might differ across different regions. To address this issue effectively, it is crucial to gain a comprehensive understanding of the problem by utilising the most up-to-date and relevant data available. The aim of this study was to assess the impact of chronic pain on the quality of life and gender of the patients attending a primary healthcare centre. We conducted a cross-sectional quantitative study among chronic care patients at Soshanguve Community Health Centre (CHC). The study utilized a validated Wisconsin Brief Pain Questionnaire to collect data. A total of 331 patients actively participated in the study. The prevalence of chronic pain was 21.5% [95% CI: 17.0-25.9]. Females were affected more frequently than male patients, chronic pain was 11.1% greater in females than in male. Furthermore, chronic pain mildly impacted the general activity of patients 33.8% [95% CI: 23.9-45.4], mood 42.3% [ 95% CI: 31.4-53.8], walking ability 29.6% [95% CI: 20.2-41.0], relationships 47.9% [95% CI: 36.7-59.3), sleep 31.0% [95% CI: 21.4-42.5], enjoyment of life 39.4% [95% CI: 28.9-51.1] and normal working ability 25.3% [ 95% CI: 16.7-36.6]. The exact Fisher test conducted to assess the association between the experienced chronic pain and its impact on the quality of life yielded a significant result, with a p-value of 0.0071 (p < 0.05). This indicates that a considerable number of patients are currently enduring chronic pain that has a noticeable effect on their overall quality of life. These findings offer invaluable insights that are essential for enhancing resource allocation at the primary care level and facilitating a more comprehensive evaluation of pain management in our communities.

Identifying populations with chronic pain in primary care: developing an algorithm and logic rules applied to coded primary care diagnostic and medication data

BackgroundEstimates of chronic pain prevalence using coded primary care data are likely to be substantially lower than estimates derived from community surveys. Most primary care studies have estimated chronic pain prevalence using data searches confined to analgesic medication prescriptions. Increasingly, following recent NICE guideline recommendations, patients and doctors opt for non-drug treatment of chronic pain thus excluding these patients from prevalence estimates based on medication codes. We aimed to develop and test an algorithm combining medication codes with selected diagnostic codes to estimate chronic pain prevalence using coded primary care data.MethodsFollowing a scoping review 4 criteria were developed to identify cohorts of people with chronic pain. These were (1) people with one of 12 (‘tier 1’) conditions that almost always results in the individual having chronic pain (2) people with one of 20 (‘tier 2’) conditions included when there are also 3 or more prescription-only analgesics issued in the last 12 months (3) chronic neuropathic pain, or (4) 4 or more prescription-only analgesics issued in the last 12 months. These were translated into 8 logic rules which included 1,932 SNOMED CT codes.ResultsThe algorithm was run on primary care data from 41 GP Practices in Lambeth. The total population consisted of 386,238 GP registered adults ≥ 18 years as of the 31st March 2021. 64,135 (16.6%) were identified as people with chronic pain. This definition demonstrated notably high rates in Black ethnicity females, and higher rates in the most deprived, and older population.ConclusionsEstimates of chronic pain prevalence using structured healthcare data have previously shown lower prevalence estimates for chronic pain than reported in community surveys. This has limited the ability of researchers and clinicians to fully understand and address the complex multifactorial nature of chronic pain. Our study demonstrates that it may be possible to establish more representative prevalence estimates using structured data than previously possible. Use of logic rules offers the potential to move systematic identification and population-based management of chronic pain into mainstream clinical practice at scale and support improved management of symptom burden for people experiencing chronic pain.

Increases in Sleep Difficulties and Psychological Symptoms are Associated With the Increase of Chronic Back Pain in Adolescents: The HBSC Study 2002 to 2018

Cross-national research using data from the Health Behavior in School-aged Children (HBSC) survey showed an increase in the prevalence of chronic back pain from 2002 to 2014. However, it is unknown if this trend has persisted beyond 2014. The aims of this study were to 1) determine if the prevalence of chronic back pain in girls and boys aged 11, 13, and 15 continued to increase from 2014 to 2018 and if this was the case, 2) examine whether this increase in the prevalence of chronic back pain between 2002 and 2018 was explained indirectly by increases in sleep difficulties and psychological symptoms. Data from 7,89,596 adolescents retrieved from 5 waves of the HBSC survey conducted in 2002, 2006, 2010, 2014, and 2018 in 32 countries/regions were used. Logistic regressions and path analyses were conducted. Results showed an overall increase of .5% in the prevalence of chronic back pain between 2014 and 2018, ranging from .4% for 15-year-old girls to 1.3% for 11-year-old boys, indicating a continued overall increase in chronic back pain in adolescents beyond 2014. For 13-year-old girls and for 15-year-old girls and boys, the increase in the prevalence of chronic back pain between 2002 and 2018 was partially mediated by increases in sleep difficulties, which in turn were associated with increases in psychological symptoms. The findings provide important information that may aid stakeholders in enhancing public health initiatives to prevent or reduce the increasing trend in the prevalence of chronic back pain in adolescents. PerspectiveThis study shows that chronic back pain prevalence continues to increase among adolescents, with sleep difficulties and psychological symptoms contributing significantly to this trend. The findings provide insights that may inform strategies to prevent or reduce the increasing trend of chronic back pain in adolescents.

Flourishing among Children and Adolescents with Chronic Pain and Emotional, Developmental, or Behavioral Comorbidities.

Pediatric chronic pain is an important public health issue given its notable impact on numerous domains of living. Pediatric chronic pain is also often comorbid with emotional, developmental, or behavioral conditions, which can lead to more severe negative outcomes and an even greater reduction in positive outcomes compared to those without comorbidities. Flourishing is a positive outcome that chronic pain status has been shown to impact. Flourishing in children aged 6-17 years living with chronic pain, as well as those with chronic pain and comorbidities, was explored using data from the 2018/2019 National Survey of Child Health. Chronic pain occurred in 4.0% of our sample, and the prevalence of chronic pain plus comorbidities was 3.9%. There were significant associations between the chronic pain condition status and all demographic variables (sex, age, race/ethnicity, poverty level, parental education, and health insurance status). The results of the hierarchical logistic regression found that the chronic pain condition status significantly predicted flourishing. Children with chronic pain were 2.33 times less likely to flourish, and children with chronic pain plus an emotional, developmental, or behavioral comorbidity were 13 times less likely to flourish than their typical peers. Given their significantly lower likelihood of flourishing, there is an urgent need for interventions targeted at children experiencing chronic pain and mental health comorbidities.

Prevalence of chronic pain and chronic widespread pain among subjects with heart failure in the general population: The HUNT study.

Pain in chronic heart failure (HF) is a significant but often unrecognized symptom. Characteristics of pain in subjects with HF are largely undescribed. The study aimed to address a knowledge gap in the relationship between HF and pain by investigating the prevalence of chronic pain and chronic widespread pain (CWP) among subjects with HF. Population data from the HUNT3 study in Norway (2006-2008, n = 50,802) was used. HF was measured by self-report. CWP was defined as having pain in both sides of the body, pain in the upper and lower limbs, and axial pain for at least 3 months in the last year. Associations between HF and CWP and HF and moderate to high pain intensity were analysed with logistic regression. Among subjects with HF in the general population, the prevalence of chronic pain was 67.8%, 20.7% had CWP, and 58.8% had moderate to high intensity pain. Compared to participants with cardiovascular disease but not HF, the odds of both CWP (OR = 1.6; 95% CI: 1.3-2.0) and moderate to high intensity pain (OR = 1.3; 95% CI: 1.3-1.8) were higher among participants with HF-controlled for age, sex, body mass index, and comorbidity. Our study confirmed the high prevalence of pain among HF subjects. This pain could not be explained by comorbidity or sociodemographic factors, which are relevant for clinical and research purposes. Pain management should not be restricted to cardiac-related pain but to chronic pain in general. This epidemiological study corroborates previous studies reporting a high prevalence of pain in the HF-population. We found that the relationship between HF, CWP, and pain intensity could not be explained by comorbidity or sociodemographic factors, illustrating the burden of chronic pain related to HF. Our results expand the understanding of pain in HF and highlight the need to identify and manage chronic pain among individuals with HF, as widespread pain adds to the symptom burden in individuals with HF.

Utilization of Methods for Pain Treatment and Management Among Older Adults with Chronic Pain

BackgroundOlder adults have a high prevalence of chronic pain, which can have a substantial effect on their health and quality of life. Patients’ use of effective pain relief methods is a central part of the treatment and management of chronic pain. The utilization of pain relief methods and their perceived effectiveness are important knowledge for treating and managing chronic pain for clinicians and older adults. However, this has been poorly investigated. AimWe aimed to survey the methods used by older people to treat and manage chronic pain as well as their perceived effectiveness. MethodsA total of 2,000 questionnaires were sent to a random sample of people aged 65 years of age or older living in Sweden and 1,141 questionnaires were returned in usable condition. A total of 433 participants reported having chronic pain and completed the Pain Management Inventory to map the use and perceived effectiveness of used treatment and management methods. ResultsThe prevalence of chronic pain was 38% and the most used pain treatment methods were passive approaches, i.e., rest (60%), distractions (53%), non-prescribed medicine (49%), and prescribed medicine (44%). A total of 72% of respondents used either prescribed or non-prescribed medicine. The most used active treatment was physical activity (52%). The perceived effectiveness varied to a large extent for each method, and, on average, no treatment method seemed to be more effective than any other. ConclusionsKnowledge about the actual use of pain treatment methods and the varied perceived effectiveness can guide clinicians in recommending new approaches or alternatives to manage chronic pain in older adults. How used methods are aligned with current clinical recommendations could be further explored in the future.

Low Back Pain and the Social Determinants of Health: A Systematic Review and Narrative Synthesis: A Critically Appraised Paper

Focused Clinical Question: In adult patients with persistent low back pain, what relationship do social determinants of health have on pain frequency or severity? Bottom Line: This systematic review identified several particular social risk factors (including education status, socioeconomic status, and occupational factors) that are consistently associated with adverse low back pain outcomes. In addition, the analysis of the population-representative (cross-sectional) studies demonstrated support for important associations between specific social determinants of health, such as low socioeconomic status/income status and employment status and chronic low back pain prevalence.

Effect of transcutaneous electrical acupoint stimulation on postoperative cognitive function in older patients with lung cancer: A randomized, double-blind, placebo-controlled trial

ObjectiveThis trial was to examine the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive function in older patients who underwent thoracoscopic pulmonary resection. MethodsThis was a prospective, randomized, double-blind, placebo-controlled study. 128 patients scheduled for surgery were randomly assigned to the TEAS group and sham-TEAS group. A standardized intervention of TEAS or sham-TEAS on the acupoints of Baihui (DU20) and bilateral Neiguan (PC6), Hegu (LI4), and Zusanli (ST36) from 30 min before anesthesia induction until the end of the surgery, combined with a general anesthetic protocol performed in the two groups respectively. The primary outcome was the incidence of postoperative cognitive dysfunction (POCD) assessed via the Montreal Cognitive Assessment (MoCA) scale at each time point. The secondary outcomes included the results of the Mini-Mental State Examination (MMSE) score, the Numerical Rating Scale (NRS) on pain and sleep, the European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ-C30), and a chronic pain questionnaire at relative time points. ResultsParticipants who completed the 12-month trial of the two groups were well-matched in baseline demographic and clinical parameters. At postoperative day 1, day 7, and day 30 time points, the incidence of POCD in the sham-TEAS group was always significantly higher than in the TEAS group (65.4% vs 20%, 43.6% vs 7.3%, 40% vs 3.6%, all P < 0.001). Also, the TEAS group showed better scores of MMSE, sleep, and pain compared with the sham-TEAS group (all P < 0.001). At 6 and 12 months points, the global health scores of the TEAS group were still significantly higher than the sham-TEAS group, and the prevalence of chronic pain was significantly lower than the sham-TEAS group (all P < 0.05). ConclusionTEAS could effectively improve the postoperative cognitive function and long-term life quality of geriatric patients with lung cancer.