Chronic Pain Fatigue Research Articles

Fatigue and cognitive fatigability in patients with chronic pain.

Fatigue is common in patients with chronic pain. Still, there is a lack of studies examining objectively measurable cognitive aspects of fatigue: cognitive fatigability (CF). We aimed to investigate the presence of CF in patients with chronic pain and its relation to self-rated fatigue, attention, pain characteristics, sleep disturbance, depression, and anxiety. Two hundred patients with chronic pain and a reference group of 36 healthy subjects underwent a comprehensive neuropsychological test battery, including measurement of CF with the Wechsler Adult Intelligence Scale-III Coding subtest, and self-assessment of trait and state fatigue. The patients with chronic pain did not show more CF as compared to the reference group. There was an association between CF and processing speed on a test of sustained and selective attention in the chronic pain group, while self-rated fatigue measures and pain characteristics were not associated with CF. Self-rated fatigue measures were highly correlated with self-rated pain intensity, spreading of pain, depression, anxiety, and sleep disturbance. The findings highlight the distinction between objective and subjective aspects of fatigue in chronic pain, and that the underlying causes of these different aspects of fatigue need to be studied further.

Cognitive and mental fatigue in chronic pain: cognitive functions, emotional aspects, biomarkers and neuronal correlates—protocol for a descriptive cross-sectional study

IntroductionChronic pain (CP) is one of the most frequently presenting conditions in health care and many patients with CP report mental fatigue and a decline in cognitive functioning. However, the...

EXPLORING THE EFFICACY AND SAFETY OF CANNABIS IN THE MANAGEMENT OF FIBROMYALGIA

Fibromyalgia is a chronic health condition characterized by chronic pain fatigue, sleep disturbances and many other symptoms affecting a patient’s quality of life. Patients with fibromyalgia often visit rheumatology outpatients with a long list of symptoms and often receive multiple medications. Many have seen multiple specialists and have done a lot of reading about alternative modalities of treatment. The limited effectiveness of conventional therapy coupled with widespread media attention raises the question of cannabis use.
 This review examines the literature on cannabinoid use in fibromyalgia against the context of the international variation in legal frameworks, the available products and the outcomes reported. A detailed review was performed using the EMBASE and PUBMED databases.
 It was concluded that despite the interest in the use of cannabinoids in the management of fibromyalgia, there is insufficient evidence to prescribe the currently available licensed medicines or to recommend the complementary health products available for legal purchase.
 There is a need for more global clinical randomised trials to accurately determine medicinal cannabis short and long-term long efficacy and safety for its acute and chronic use.

Change in fatigue in acceptance and commitment therapy-based treatment for chronic pain and its association with enhanced psychological flexibility.

Fatigue is commonly reported by people with chronic pain. The purpose of the current study was to examine Acceptance and Commitment Therapy (ACT), based on the Psychological Flexibility (PF) model, for fatigue in chronic pain. This study included 354 adults attending an interdisciplinary ACT-oriented treatment for chronic pain. T-tests and analyses of clinically meaningful change were used to investigate participant improvements in fatigue interference after the treatment. Pearson's correlations and hierarchical regressions were conducted to investigate associations between improvement in fatigue interference and improvements in PF processes. Finally, mixed effects models were used to explore associations between baseline fatigue interference and changes in treatment outcome measures. Participants improved in fatigue interference (d = 0.37), pain, some PF processes and daily functioning (d = 0.18-1.08). 39.7% of participants demonstrated clinically meaningfully improvements in fatigue interference. Changes in fatigue interference was associated with changes in pain, PF processes and daily functioning, |r| = 0.20-0.46. Change in fatigue interference was associated with change in pain acceptance independent of change in pain, β = -0.36, p < .001. However, baseline fatigue interference did not predict any treatment outcome. Overall, people with fatigue appeared to benefit from the ACT-oriented interdisciplinary treatment for chronic pain, and relatively higher levels of fatigue did not appear to impede this benefit. ACT-based treatments may benefit people with chronic pain and fatigue. Future studies including experimental designs, and studies investigating other PF processes, are needed to better understand the utility of ACT for comorbid fatigue and pain. This study investigates the association between fatigue interference and psychological flexibility processes in chronic pain, and the first one investigating fatigue interference as a predictor of functioning in chronic pain following Acceptance and Commitment Therapy (ACT)-based treatment. Findings of the study provide preliminary evidence for the association between ACT and fatigue in people with chronic pain and support the potential benefit of ACT for people with comorbid chronic pain and fatigue.

(272) An 8 Week Modified Yoga Program for Chronic Pain

The utilization of complementary care is on the rise for patients with chronic pain, partly due to the opioid epidemic and recent guidelines stating opioids are ineffective for chronic pain. Physical activity is a primary recommendation for various types of chronic pain. The 2007 National Health Interview Survey found that U.S. adults are choosing yoga as one of the top 10 complementary approaches. Stemming from ancient Indian philosophy, yoga is a mind-body practice that typically combines physical postures, breathing techniques and meditation. Yoga has been shown to have neuroprotective effects on the brain, possibly even reversing the effects of chronic pain. Patients with chronic pain can be hesitant to start yoga due to the public's view of needing to be flexible and fit in order to do yoga. People with chronic pain may also fear exercise due to past experiences that flared their pain. There are many different schools and types of yoga available, making it confusing to choose a class to attend. Therefore, we developed an 8 week “yoga for chronic pain” program to introduce the benefits of yoga and modify the yoga practice for patients with chronic pain. There is a weekly didactic on how yoga can be helpful for various aspects of chronic pain-fatigue, sleep, improved mood. This is followed by a gentle guided posture, breathing and meditation practice. Participants are given a variety of resources, encouraged to start a home practice and log their minutes of practice each week. In 2018, we had two groups of patients complete our 8-week yoga program and we measured their pain interference, sleep, mood, and pain medication usage at the start, end and 3 months following completion of our program. In this poster, we will present our findings (currently under analysis). (Villemure, et al, Cerebral Cortex 2014)

Tired of pain? Toward a better understanding of fatigue in chronic pain.

1. Why we need a better understanding of fatigue in chronic painFatigue is a prevalent complaint in people with chronic pain.11,46 A study in the general population showed that 64% of the individuals with chronic widespread pain reported co-occurring persistent fatigue.13 In patients with chronic pa

Physical and Psychological Correlates of Fatigue and Physical Function: A Collaborative Health Outcomes Information Registry (CHOIR) Study

Fatigue is a multidimensional construct that has significant implications for physical function in chronic noncancer pain populations but remains relatively understudied. The current study characterized the independent contributions of self-reported ratings of pain intensity, sleep disturbance, depression, and fatigue to ratings of physical function and pain-related interference in a diverse sample of treatment-seeking individuals with chronic pain. These relationships were examined as a path modeling analysis of self-report scores obtained from 2,487 individuals with chronic pain from a tertiary care outpatient pain clinic. Our analyses revealed unique relationships of pain intensity, sleep disturbance, and depression with self-reported fatigue. Further, fatigue scores accounted for significant proportions of the relationships of both pain intensity and depression with physical function and pain-related interference and accounted for the entirety of the unique statistical relationship between sleep disturbance and both physical function and pain-related interference. Fatigue is a complex construct with relationships to both physical and psychological factors that has significant implications for physical functioning in chronic noncancer pain. The current results identify potential targets for future treatment of fatigue in chronic pain and may provide directions for future clinical and theoretical research in the area of chronic noncancer pain. PerspectiveFatigue is an important physical and psychological variable that factors prominently in the deleterious consequences of pain intensity, sleep disturbance, and depression for physical function in chronic noncancer pain.