Experience Of Musculoskeletal Pain Research Articles

Influence of musculoskeletal pain during gait on kinematics and selective motor control in individuals with spastic cerebral palsy: A pilot study.

Individuals with cerebral-palsy commonly present with altered kinematics and selective-motor-control during gait, and may also experience musculoskeletal pain. This pilot study aims to investigate if the immediate experience of musculoskeletal pain during gait influences kinematics and selective-motor-control in individuals with spastic cerebral-palsy. Retrospective treadmill-based gait-analysis data for 145 individuals with spastic cerebral-palsy were screened. Participants were asked about experiencing lower-extremity musculoskeletal pain immediately during gait, with 26 individuals (18%) reporting this was the case (pain-group; mean 11.55±3.15years, Gross-Motor-Function-Classification-System levels I/II/III n=5/13/8, Uni/bilateral involvement n=11/15). Of the 77 individuals who did not report any pain, a no-pain group (n=26) was individually matched. Kinematics were evaluated using the Gait-Profile-Score and spatiotemporal parameters (dimensionless-walking-speed, single-leg-support percentage and step-time). Selective-motor-control was assessed using the Walking-Dynamic-Motor-Control index. In the pain-group, 58% reported experiencing pain in their more-involved leg, 8% in the less-involved leg and 34% in both legs. Regarding the pain location, 38% of the pain-group reported experiencing pain in multiple locations. On a more specific level, 35%, 46% and 54% reported pain around the hip/thigh, knee/calf and ankle/ft, respectively. No significant differences were observed between the pain and no-pain groups for any of the outcome measures, in each leg or bilaterally. No significant differences in kinematics and selective-motor-control during gait were found between individuals with spastic cerebral-palsy, with and without musculoskeletal pain. This suggests that the individuals in this study may not present with obvious antalgic gait patterns, which may relate to the pre-existing altered kinematics and selective-motor-control.

Through the Lens of Movement-Evoked Pain: A Theoretical Framework of the “Pain-Movement Interface” to Guide Research and Clinical Care for Musculoskeletal Pain Conditions

Over 120 million Americans report experiencing pain in the past 3 months. Among these individuals, 50 million report chronic pain and 17 million report pain that limits daily life or work activities on most days (ie, high-impact chronic pain). Musculoskeletal pain conditions in particular are a major contributor to global disability, health care costs, and poor quality of life. Movement-evoked pain (MEP) is an important and distinct component of the musculoskeletal pain experience and represents an emerging area of study in pain and rehabilitation fields. This focus article proposes the “Pain-Movement Interface” as a theoretical framework of MEP that highlights the interface between MEP, pain interference, and activity engagement. The goal of the framework is to expand knowledge about MEP by guiding scientific inquiry into MEP-specific pathways to disability, high-risk clinical phenotypes, and underlying individual influences that may serve as treatment targets. This framework reinforces the dynamic nature of MEP within the context of activity engagement, participation in life and social roles, and the broader pain experience. Recommendations for MEP evaluation, encompassing the spectrum from high standardization to high patient specificity, and MEP-targeted treatments are provided. Overall, the proposed framework and recommendations reflect the current state of science in this emerging area of study and are intended to support future efforts to optimize musculoskeletal pain management and enhance patient outcomes. PerspectiveMovement-evoked pain (MEP) is a distinct component of the musculoskeletal pain experience and emerging research area. This article introduces the “Pain-Movement Interface” as a theoretical framework of MEP, highlighting the interface between MEP, pain interference, and activity engagement. Evaluating and treating MEP could improve rehabilitation approaches and enhance patient outcomes.

Prevalence, incidence, and re-occurrence risk of musculoskeletal pain in older adults in the United Kingdom: a population-based study.

Throughout the literature, pain burden has been assessed by asking different questions, often cross-sectionally, different populations of interest. We know little about pain re-occurrence and how to translate knowledge between pain questions within the population of interest. We aimed to estimate the burden of musculoskeletal pain by estimating prevalence, incidence rates, and re-occurrence risk of back, hand, hip, knee, and foot pain using different questions from UK population-based samples and predict the number of affected individuals in the UK in 2030. We used two UK population-representative studies, with two eight-year-apart follow-ups and two pain questions assessing recent pain episodes and often troubled pain when walking. We estimated prevalence, 8-year incidence rates, and 8-year pain re-occurrence risk for women and men aged 50 years and older and the relation between the two pain questions. Among UK individuals older than 50 years, the prevalence of musculoskeletal pain episode was 20%-50%, and the incidence was 20-40/1,000 person-years, while the prevalence of pain when walking was 10%-25%, and the incidence was 6-12/1,000 person-years. The most prevalent musculoskeletal pain types were back and knee pain; of five women experiencing back or knee pain episodes, three are expected to be often troubled by pain. Hip and foot pain had similar estimates in both questions. Hand pain peaked in women aged 50-65 years. Women had higher prevalence and incidence rates, but men had higher 8-year re-occurrence risk of all types of musculoskeletal pain. Reporting a pain episode was associated with two times higher risk, but often troubled by pain when walking was associated with four to seven times times higher risk of the same pain in 8 years. Women and men with a body mass index (BMI) of ≥27 kg/m2 were twice as likely to experience musculoskeletal pain than those with BMI<27 kg/m2. In 2030, we expect 2-7 million people older than 50 years in the United Kingdom to seek site-specific musculoskeletal pain-focused healthcare. In individuals older than 50 years, the experience of musculoskeletal pain at least doubles the chance of experiencing it again. Women report musculoskeletal pain more often, but men report more persistent pain. Musculoskeletal pain presents a significant burden to public health.

Perception of Heaviness Induced by Sensorimotor Incongruence Is Associated with Pain Prognosis: A Pilot Study.

Patients with chronic musculoskeletal pain experience not only pain but also abnormal body perception. Such abnormal body perception has been reported to be caused by incongruence between motor intentions and sensory feedback (i.e., sensorimotor incongruence). However, the influence of abnormal body perception with sensorimotor incongruence on pain prognosis in musculoskeletal pain patients has not been investigated. We aimed at clarifying the influence of abnormal body perception on pain prognosis using an experimental procedure for inducing sensorimotor incongruence in patients with musculoskeletal pain. We recruited 18 patients within 2 months after limb fracture or ligament injury. In the experiment, patients sat with the intact upper or lower limb reflected in a large mirror aligned with the sagittal plane. A motor task was performed for 20 seconds in each of the congruent and incongruent conditions. In the congruent condition, patients were asked to perform flexion-extension movements with the intact and affected limbs in-phase, while observing the intact limb in the mirror. In the incongruent condition, patients were asked to perform flexion-extension movements antiphase, while observing the intact limb in the mirror. After performing the congruent and incongruent conditions, patients were asked to complete a questionnaire about abnormal body perception. These procedures were conducted within 2 months after the fracture (first), 2 weeks after the first measurement (second), and 4 weeks (third) after the first measurement. Pain, heaviness, and peculiarity were more likely to be experienced in incongruent conditions. Additionally, structural equation modeling indicated that heaviness at the first time point predicted the pain intensity at the second and third time points. Heaviness caused by sensorimotor incongruence may predict pain prognosis in patients with musculoskeletal pain after one month.

Quality of life in working populations with and without musculoskeletal pain in Saudi Arabia.

Musculoskeletal (MSK) pain can negatively affect work life and quality of life (QoL). This study characterizes the QoL of workers in Saudi Arabia and compares it between adults of working age with and without MSK pain. This is a descriptive cross-sectional study. The Short Form-36 (SF-36) instrument was used to measure eight domains that describe QoL among workers with and without MSK pain. Descriptive statistics and parametric tests enabled comparisons between the two sets of workers. A total of 2042 workers participated in the study. The majority of them had experienced MSK pain during the last 12 months. In addition, the results for most SF-36 domains varied significantly across age and gender groups. Workers who lacked MSK pain over the last 12 months reported higher means for all SF-36 domains, with the exception of the physical function domains. This study found that the majority of workers experience MSK pain. In all bodily regions, neck and back pain are the most frequently reported areas of discomfort for these employees. Workers without MSK pain experience better QoL. This observation suggests the need for managers to pay closer attention to workers with MSK pain, as these employees experience significantly lower QoL. To prevent or reduce MSK pain, workers should undergo routine medical examination and early intervention for MSK pain. These preventative measures can help to increase workers' QoL.

Association between pelvic pain bothersomeness and pain sensitivity: A community-based cross-sectional study of young adult females in the Raine Study.

Pelvic pain has been associated with augmented nociceptive processing, but large studies controlling for multiple potential confounding factors are lacking. This study investigated the association between pelvic pain bothersomeness and pain sensitivity in young adult women, accounting for potential confounding factors. Cross-sectional study. Community-dwelling sample. The Raine Study Gen2-22 year follow-up (n=475). The experience of bothersomeness related to pelvic pain was determined from a question in the Urogenital Distress Inventory short form. Pain sensitivity was measured using pressure pain and cold pain thresholds. Potential confounding factors included ethnicity, marital status, highest level of education, income, waist-hip ratio, level of activity, sleep quality, smoking, comorbidity history, C-reactive protein level, musculoskeletal pain experience and psychological distress. Three hundred and sixty-two women (76.2%) reported no pelvic pain bothersomeness, 74 (15.6%) reported mild pelvic pain bothersomeness and 39 (8.2%) reported moderate-severe pelvic pain bothersomeness. After adjusting for marital status (and test site), moderate-severe pelvic pain bothersomeness was associated with a lower pressure pain threshold (i.e. greater pressure pain sensitivity) (coefficient -51.46, 95%CI -98.06 to -4.86, p=0.030). After adjusting for smoking, moderate-severe pelvic pain bothersomeness was also associated with a higher cold pain threshold (i.e. greater cold pain sensitivity) (coefficient 4.35, 95%CI 0.90-7.79, p=0.014). This study suggests augmented nociceptive processing as a contributing factor in pelvic pain bothersomeness for some women. Thorough assessment of women who present clinically with pelvic pain should consider pain sensitivity as a potential contributing factor to their presentation.

Adolescents\u2019 experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis

BackgroundAdolescents with chronic musculoskeletal pain experience daily fluctuations in pain. Although not all fluctuations are bothersome, pain flares are a distinct type of symptom fluctuation with greater impact. Since literature on the experience of pain flares is non-existent, the aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders in order to (ii) identify knowledge gaps to inform future research on pain flares.MethodsElectronic databases (CINAHL, MEDLINE, EMBASE, PsycINFO), grey literature and reference lists were searched from inception to June 2018 for qualitative studies reporting adolescents’ experiences of pain. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research. Studies were analysed using thematic synthesis.ResultsOf the 3787 records identified, 32 studies (n = 536) were included. Principal findings were synthesised under three key themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. The first theme (symptom experience) describes adolescent’s perception and interpretation of pain fluctuations. The second theme (disruption and loss) describes the physical, social and emotional constraints faced as a result of changes in pain. The third theme (regaining control) describes coping strategies used to resist and accommodate unpredictable phases of pain. Each theme was experienced differently depending on adolescents’ characteristics such as their developmental status, pain condition, and the duration of the pain experience.ConclusionsAdolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It was not clear whether these symptoms and challenges were experienced as part of ‘typical’ fluctuations in pain, or whether they reflect symptom exacerbations classified as ‘flares’. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their typical fluctuations in pain. The review also highlights areas relating to the pain experience, symptom management and health service provision that require further exploration to support more personalised, tailored care for adolescents with chronic musculoskeletal pain.

Chronic musculoskeletal pain experiences in marginalized populations: a mixed methods study protocol to understand the influence of geopolitical, historical, and societal factors

Background: Chronic musculoskeletal pain (CMP), an invisible disease, is due to complex biological and psychological processing. A CMP epidemic occurs concurrently during historically high global population movement. Nationalistic geopolitical rhetoric arises, in part, in response to perceptions of increased immigration rates and healthcare policies. Limited evidence exists about the impact of the current geopolitical climate on the CMP experience amongst migrant populations. Strategies to improve inequitable CMP management in marginalized populations may include improving the clinical conversation. Effective communication is a critical part of pain management and successful interactions between patients and their healthcare providers. Aims: The primary aims are to 1) develop subgroups of self-reported pain experiences in people who have CMP and experience marginalization and 2) interpret the pain experience of marginalized populations with CMP in the context of geopolitical, historical, and societal influences. Methods: A mixed methods sequential explanatory design study will be used. The first quantitative phase will be a survey, to be completed in three languages, with questions related to pain status, patient beliefs, and perspectives on healthcare. Latent class analysis will be used to generate experience-based subgroups. Focus groups will provide nuanced descriptions of the patient experience. Discussion: Results from this study will inform the understanding of the influence of geopolitical, historical, and societal influences on CMP in people who experience marginalization. This understanding will be used to develop a framework to educate clinicians on the broader factors in the CMP experience and to consider steps that can mitigate inequitable CMP outcomes in marginalized populations.HighlightsMarginalized patient populations may have different experiences in CMP.Societal and historical policies may influence clinical conversations and outcomes.CMP management may be impacted by the contemporary geopolitical environment.A mixed-method protocol is established to interpret patients’ CMP experiences in people who may experience marginalization.

The Effect of Number of Patients Treated, Dental Loupes Usage, Stress, and Exercise on Musculoskeletal Pain among Dentists in Jeddah.

ABSTRACTObjectives:The aim of this study was to investigate the prevalence of musculoskeletal pain (MSP) and to explore its potential risk factors among dentists in Jeddah, Saudi Arabia.Materials and Methods:A cross-sectional survey of private and government dentists in Jeddah, Saudi Arabia was undertaken between January and December 2018. A self-administered questionnaire was distributed randomly to consenting participants. Descriptive data analysis involved measures of central tendency and percentages, t test, chi-square, and logistic regression analysis were used to evaluate relationships among the variable “having MSP experience after dental work” and other potential predictors among dentists.Results:A total of 300 dentists completed the questionnaires. The overall prevalence of MSP was 68%, with back pain as the most frequently reported symptom (54%). The results revealed significant association of MSP with number of patients treated per day, nonuse of dental loupes during dental work, stress, and lack of regular exercise (P < 0.05).Conclusion:The prevalence of MSP among dentists in Jeddah is high attributable to poor ergonomics and stress, which further impact the quality of life of practitioners.

Transferring patients’s experiences of change from the context of physiotherapy to daily life

ABSTRACT Purpose: In the treatment of patients with long-lasting musculoskeletal pain, the challenge is to identify causal and sustaining factors and targeted treatment in order to improve function. Norwegian Psychomotor Physiotherapy (NPMP) is an approach often applied to patients with such pain. Long-term NPMP processes from the patients’ perspective have been studied and discussed in the light of phenomenology of the body. The study purpose was to explore what kind of changes patients with long-lasting musculoskeletal pain experience during NPMP and further transfer into daily life context. Methods: A phenomenological, descriptive, and retrospective design was applied. Two focus-group interviews were conducted with 11 patients receiving such treatment. The interviews were audiotaped, transcribed, and analysed inspired by Giorgi’s phenomenological methodology. Results: The analysis resulted in an overarching structure: “To develop embodied ownership of oneself over time”, and two themes describing the essence of change that the patients experienced: (1) “To get an embodied grip on oneself through treatment”; (2) “To give oneself space in daily life”. Conclusions: Enhanced embodied self-perception involving a sense of embodied ownership and agency seemed to be important both to be aware of own bodily needs and to transfer changes from treatment into daily life.

Musculoskeletal Pain Medication Use in Middle Age and Older Adults in 15 European Countries and Israel

BackgroundThe experience of musculoskeletal pain is widespread among adults and entails high costs to both individuals and society. Few studies look at disparities in pain management. AimsTo examine factors associated with the presence of musculoskeletal pain and the use of pain medication use among individuals aged 50+. DesignCross-sectional analysis of data from the SHARE. Participants64,281 community-dwelling individuals in 15 European countries and Israel. MethodsBivariate analysis and logistic regression were used to identify factors associated with the presence of musculoskeletal pain and pain medication use. ResultsAmong our population, the prevalence of musculoskeletal pain at the time of the survey was 40.1%. Women had more pain than men (odds ratio [OR] = 1.477, confidence interval [CI] = 1.428-1.528), those who were 60-69 years old had less pain than younger individuals (OR = 0.927, CI = 0.883-0.973), whereas those who were 80+ years old had more pain than younger individuals (OR = 1.280, CI = 1.199-1.367). About 50% of those with musculoskeletal pain take no medication to manage it. Predictors of pain medication use include male sex (OR = 1.468, CI = 1.389-1.553), more education (OR = 1.034, CI = 1.023-1.041), and better ability to cope economically (OR = 1.446, CI = 1.368-1.527). Those over 70 are less likely than younger individuals to be taking medication to manage their pain (70-79: OR = 0.822, CI = 0.761-0.887), (80+: OR = 0.619, CI = 0.566-0.677). ConclusionsNurses should be aware of the association of education and income with pain-medication use, which suggests that pain medication use is less accessible to those with fewer resources. Pain is a significant public-health problem, and access to medicine deserves attention from nurses, healthcare workers and policymakers.

P36 Adolescents’ experiences of fluctuating pain in musculoskeletal disorders: a qualitative systematic review and thematic synthesis

Abstract Background Adolescents with chronic musculoskeletal pain experience pain that fluctuates within and across days. The aim of this review was to (i) synthesise the qualitative literature on adolescents’ experiences of fluctuating pain in musculoskeletal disorders, (ii) identify the concept of pain flare and how this may differ from daily fluctuation of pain, and (ii) identify knowledge gaps to inform the design of future research. Methods Six electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, OpenGrey and Scopus) and reference lists of relevant articles were searched from inception to June 2018. Articles were eligible for inclusion if they were qualitative studies exploring the experiences of pain in adolescents, aged between 10–19 years, diagnosed with juvenile idiopathic arthritis (JIA) and chronic idiopathic pain syndromes (CIPS). Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research (COREQ) framework, and studies were analysed using thematic synthesis. Results Of the 3,787 records identified, 32 studies were included from 11 countries. 536 young people with JIA or CIPS participated in the studies, of which 509 had a diagnosis of JIA, and 27 with CIPS. Interviews were conducted in 29 studies, with 9 studies also combining interviews with focus groups, observations, questionnaires, researcher journaling, visual depictions and diaries. Although all included studies reported adolescent’s experience of pain, only 19 studies provide insight into the impact of fluctuating pain on an individual’s life and lived experience. 21 studies included data from parents, siblings, health professionals and/or individuals with other chronic illnesses, but efforts were made to only extract data referring to or expressed by adolescents with JIA or CIPS. Ages of patients ranged from 3 to 23 years, but all studies averaged within the adolescent range. Principal findings were synthesised under three themes: 1) symptom experience, 2) disruption and loss, and 3) regaining control. These themes can be seen to describe a journey through which the adolescent experiences fluctuating pain and associated symptoms, encounters the challenges to lifestyle that fluctuating pain presents, followed by employing coping strategies to regain a sense of control of their lives and pain. Each stage is experienced differently depending on individual factors such as adolescents’ developmental status, pain condition, and duration of the pain experience. Conclusion Adolescents with chronic musculoskeletal pain live with a daily background level of symptoms which frequently fluctuate and are associated with functional and emotional difficulties. It is not clear whether these symptoms and challenges are experienced as part of normal fluctuations in pain, or whether they reflect symptom exacerbations classified as flares. Further research is needed to explore the frequency and characteristics of pain flares, and how they differ from their normal fluctuations in pain. Conflicts of Interest The authors declare no conflicts of interest.

Central Sensitization Inventory Mediates the Relationship Between Inflammatory Bowel Disease Activity and Worse Musculoskeletal Pain Experiences.

Musculoskeletal conditions are well documented in inflammatory bowel disease (IBD). However, whether IBD activity influences musculoskeletal pain experiences is uncertain. Central sensitization has been proposed in patients with IBD who are suffering from persistent pain. Identification of central sensitization symptomology using the Central Sensitization Inventory (CSI) has been reported in many pain-related disorders. Aims of this study were to explore predictive relationships between IBD activity and musculoskeletal pain experiences (severity/interference), and the mediating effects of the CSI. A cross-sectional online survey was performed exploring self-reported musculoskeletal pain in adults with IBD. Survey questionnaires included IBD activity indices, numeric rating scales, PROMIS Pain Interference, and the CSI. Linear regression was used to examine the relationship between active IBD and pain experiences. Simple and serial mediation analyses were used to explore mediation models: independent variable (IBD activity), dependent variables (severity/interference), and mediators (CSI/severity). 208 adults with IBD, 18 to 88years of age, reported musculoskeletal pain. Regression analysis identified IBD activity as a significant predictor of worse pain severity (R2 =0.039, P<0.005) and interference (R2 =0.067, P<0.001). Simple mediation showed a significant indirect effect from CSI scores between IBD activity and pain severity. Serial mediation analysis showed a significant indirect effect from CSI scores and pain severity, between IBD activity and pain interference. Active IBD demonstrated a positive association with worse musculoskeletal pain experiences. The CSI demonstrated significant mediation between active IBD and pain severity. Additionally, the CSI and pain severity demonstrated significant mediation between active IBD and pain interference. This suggests that symptoms of central sensitization significantly influence musculoskeletal pain experiences in IBD.

Associations Between Musculoskeletal Pain Experience and Pressure and Cold Pain Sensitivity: A Community-based Cross-sectional Study of Young Adults in the Raine Study.

To investigate the cross-sectional associations between musculoskeletal pain experience and measures of pressure and cold pain sensitivity in young adults from the Western Australian Pregnancy Cohort (Raine) Study. In total, 917 participants were eligible for analysis if they provided data pertaining to musculoskeletal pain status at the 22-year follow-up and had data for at least 1 valid pain sensitivity test. Standardized protocols were used to assess pressure pain threshold (4 sites: lumbar spine, tibialis anterior, upper trapezius, and wrist) and cold pain threshold (wrist). Four pain experience groups ("No pain" [n=562, 61.3%], "Low" [n=84, 9.2%], "Medium" [n=147, 16.0%], "High" [n=124, 13.5%]) were determined by latent class analysis using parameters of pain chronicity, frequency, intensity, and number of pain areas. Variables considered as confounders included sex, age, ethnicity, waist-hip ratio, psychological symptoms, sleep quality, physical activity, sedentary behavior, smoking, and income. There were no associations between pain experience and pressure pain sensitivity after adjusting for confounders. The "Medium" and "High" pain experience groups demonstrated heightened cold pain sensitivity compared with the "No pain" group (P=0.023), adjusted for sex and smoking. This study provides the most extensive investigation of the relationship between musculoskeletal pain experience and pressure and cold pain sensitivity in young adults. Heightened cold pain sensitivity in those classified as "Medium" and "High" pain experience may suggest altered nociceptive processing and has implications for clinical management.

Patient-defined outcomes for pain, fatigue, emotional distress, and interference with activities did not differ by age for individuals with musculoskeletal pain.

Introduction:Age impacts the prevalence and experience of musculoskeletal pain; however, it is unknown whether this factor impacts patient's anticipated outcomes after treatment.Objective:Using the Patient-Centered Outcomes Questionnaire (PCOQ), the primary purpose was to determine whether there are age-related differences in desired, successful, expected levels, and importance of improvement in pain, fatigue, emotional distress, and interference with daily activities. As a secondary purpose, anatomical location and sex were then included in the model to examine for interaction effects.Methods:A secondary analysis of the Optimal Screening for Prediction of Referral and Outcome cross-sectional and longitudinal cohorts was conducted. Included in this analysis were 572 individuals seeking physical therapy for nonsurgical neck, low back, shoulder, and knee pain who completed the PCOQ at the initial evaluation. A three-way analysis of variance examined PCOQ domains by age categories, sex, and anatomical location.Results:Interaction effects were not observed for any of the domains of interest (P > 0.01). Significant main effects were also not observed for age, sex, and anatomical location (P > 0.01).Conclusion:Musculoskeletal pain prevalence may differ across age categories but, in this cohort, neither age, nor sex, nor anatomical location impacted patient-defined outcomes for intensity, fatigue, emotional distress, and interference with daily activities.

Social Dimensions of Musculoskeletal Pain Experiences among the Elderly in Southwestern Nigeria

Musculoskeletal pain (MS pain) in the elderly has attracted more medical focus than its social dimensions. This cross-sectional survey design study, conducted in southwestern Nigeria, through a multi-stage sampling technique, documented reported MS pain in 1280 consented elderly using 3-scale pain experiences categorized as acute, semi-acute, and chronic. Also, 12 In-depth Interviews (IDIs) among elderly persons, and 15 Key Informant Interviews (KIIs) among orthodox- and traditional medicine practitioners were conducted. The age of the respondents was 65.5 ± 4, while about half (51.1%) had no formal education. Majority (76.8%) of the respondents perceived MS pain as normal process of old age. Occupational life history of the respondents ranked the highest as perceived reason for having MS pain, while the knees (19.6%) were the most identified pained location among others in the body. A high significant relationship between neck and shoulders pain (χ2 = 0.000) was however found. Social construction dimensions of the elderly were narrated, while MS pain was considered as sickness of the elders. There is need for orientation for the elderly and their helpers on the social dimensions of old age relative to Nigeria.

Patients with chronic pain may need extra support when prescribed physical activity in primary care: a qualitative study

Background: Physical activity plays an important role in the prevention and treatment of chronic musculoskeletal pain, but chronic pain may implicate a poor rehabilitation outcome. The concept of physical activity on prescription (PAP) is a therapeutic option for various diseases, but there is a lack of knowledge about how patients with chronic musculoskeletal pain experience receiving the prescription.Objectives: The objective of this study was to describe the experiences of and thoughts about receiving a prescription for physical activity of people with chronic musculoskeletal pain.Design: Interviews analysed using qualitative content analysis with an inductive approach.Setting: Three primary healthcare centres in a mixed rural and suburban area in the vicinity of a large city in western Sweden.Subjects: Fifteen individuals with chronic musculoskeletal pain.Results: Four categories were identified with the overarching theme “Physical activity in chronic pain requires extra support”. There were several barriers for increasing activity level and these patients suffered from the additional burden of pain. The categories were: “Important to identify needs”, “Barriers and facilitators for physical activity”, “Perceptions of PAP vary” and “Effects found of receiving PAP”.Conclusions: Despite the many positive experiences of receiving PAP, patients described confusion about the role and execution of PAP. Chronic pain is an additional barrier for increasing activity level, and it is crucial to consider these patients’ circumstances. This study suggests that patients with chronic musculoskeletal pain have a greater need for information and extra support to overcome existing barriers, before or when physical activity is prescribed.Key PointsPhysical activity is important for prevention and treatment of chronic pain and has earlier been shown to be increased by “physical activity on prescription”.Patients with chronic musculoskeletal pain required the prescriber to listen and take the patients’ circumstances, context, symptoms and current activity level into account to a greater extent.Patients with chronic musculoskeletal pain experienced more obstacles to increase their physical activity and, therefore, had a greater need for individually tailored information and support when prescribed physical activity.Patients with chronic musculoskeletal pain found it difficult to distinguish between physical activity on prescription and physiotherapy and perceived that also the physicians could not tell the difference.

Quality of life, depression and musculoskeletal pain experience among employed women: A controlled study.

The musculoskeletal pain is one of the leading health problems among employed women. The aim of our study was to examine musculoskeletal pain, depression and quality of life (QOL) among employed women and find out the differences with unemployed women. A hundred and fifty employed women and 151 housewives were included in our study. We used visual analog scale (VAS) for the assessment of pain, Beck Depression Inventory (BDI) for the depressive symptoms and Nottingham Health Profile (NHP) for the assessment of QOL. The ratio of musculoskeletal pain among employed women and unemployed women were found as 42.5% and 57.5% respectively. A mild level of depression was found among employed women whereas moderate and vigorous level of depression were found among unemployed women. There were significant differences in terms of depression and QOL parameters. When the correlations of pain, depression and QOL were analyzed, significant high positive relationships between spinal, lower extremity, upper extremity pain levels and BDI and NHP were found only in housewives. Lower levels of depression among employed women can give the idea that social ambience at work place, focusing at work and economic independence play a role in decreasing depression.

The Role of Language Use in Reports of Musculoskeletal Pain Among Hispanic and Non-Hispanic White Adolescents.

This study examined the role of English language use in the reported frequency of musculoskeletal pain among Hispanic and non-Hispanic White youth. This is a secondary data analysis using a cross-sectional sample of 12,189 Hispanic and non-Hispanic White adolescents recruited for the National Longitudinal Study of Adolescent to Adult Health. Respondents were classified into three groups: (a) English-speaking non-Hispanic Whites, (b) English-speaking Hispanics, and (c) Spanish-speaking Hispanics. After controlling for body mass index and demographic, socioeconomic, and behavioral variables, Spanish-speaking Hispanics reported the least frequent musculoskeletal pain ( OR = 0.415, 95% CI [0.361, 0.477]; p < .001), followed by English-speaking Hispanics ( OR = 0.773, 95% CI [0.690, 0.865]; p < .001). The experience of musculoskeletal pain is a physiological as well as a cultural phenomenon. Health care providers should consider the role of language use in reports of pain in Hispanic and non-Hispanic White adolescents.

Work-related musculoskeletal pain and health-seeking behavior among Nigerian sewing machine operators

Background: Musculoskeletal pain (MSP) is the most common occupational health risk among sewing machine operators and their health-seeking behavior is not well understood. This study assessed the prevalence, pattern, and predictors of work-related MSP and health-seeking behavior among Nigeria sewing machine operators. Materials and Methods: Three hundred and twenty-five purposively selected registered sewing machine operators who have worked for at least a year without musculoskeletal trauma participated in this cross-sectional descriptive survey. Information on MSP and health-seeking behavior were collected through questionnaire interview. Results: Almost 69% (223/325) and 98% (318/325) of the participants reported the experience of MSP in the last 7-day and 12-month, respectively. Among those who reported the experience of pain, the most common pain site was low back, followed by the neck, while the elbow was the least common pain site. When the report of experience of pain was adjusted for sex, the same pattern of body regional distribution of pain was observed. Almost 36% (116/325) reported that MSP was due to a combination of work activities and position while 21% (69/325) reported that either work activities or position resulted in MSP. Majority (88%) of participants experienced limitation in daily activities as a result of MSP. The most sought after health-seeking behavior was self-medication (31.4%) followed by herbal preparations (17.8%). Only 3.7% (12/325) sought hospital treatment only and 2.5% sought hospital treatment in addition to other treatments. Only the factor does pain limit activities predicted MSP. Conclusion: Work-related MSP is prevalent among Nigerian sewing machine operators, and low back is the most common pain site. Only the factor does pain limit activities predicted MSP. Many of them engage in self-medication to alleviate their pain.