Frequent Site Of Pain Research Articles

Prevalence and epidemiological characteristics of chronic pain in the Spanish population. Results from the pain barometer.

Chronic pain (CP) is a public health problem worldwide. To update the prevalence of CP and compare the clinical and social characteristics of people with CP with those with non-chronic continuous pain and a group without pain. An observational cross-sectional study was carried out in a representative sample of 7058 adults from the Spanish population. Sociodemographic data, the presence of CP and non-chronic continuous pain, characteristics of pain, limitations on activities of daily living (ADL), the presence and level of anxiety and depression (HADS), quality of life (SF-12v2) and social support (DUKE) were collected. Descriptive and bivariate analyses were performed. The prevalence of CP was 25.9% (95% CI;24.8-26.9) and that of non-chronic continuous pain was 7.7% (95% CI;7.1-8.3). Women presented a higher prevalence of both CP (30.5% vs. 21.3%) and non-chronic continuous pain (8.8% vs. 6.6%). CP was more common in the group between 55 and 75 years old (30.6%, 95% CI = 28.6-32.6%), non-chronic continuous pain affected most the population between 18 and 34 years old (11.2%, 95% CI = 9.6-12.7%). The median duration of CP was 4 years. The lumbar was the most frequent pain site (58.1%), and 27.1% did not know the cause. A greater frequency of limitations on ADL, more anxiety and depression, and worse quality of life were shown among the subjects with CP. CP affects one in four Spanish people and impairs the mental, physical and social health. Differences exist by sex and age in its frequency. Identifying subjects with non-chronic continuous pain is fundamental to prevent their pain from becoming chronic. Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Due to its high prevalence and impact on quality of life, chronic pain has become one of the main health problems nowadays. Attention must be paid to it both from a clinical and social perspective, trying to raise awareness among the population of its possible causes and consequences. In routine clinical practice, greater consideration is given to groups of people with a higher prevalence of chronic pain, such as women and people with middle age, and with no chronic pain to prevent the appearance of chronic pain.

PSYCHOLOGICAL FACTORS ASSOCIATED WITH CHRONIC OROFACIAL PAIN.

Pain is one of the most common symptoms encountered in clinical practice and the head is a frequent site of pain. Chronic Orofacial Pain (COP) represents a complex pain condition with an etiology comprised of many factors including those falling within biological, psychological, and social domains. Psychogenic regional pain is a term used for “pain that patients feel in a region of the body where no peripheral cause can be found and is psychogenic in its evocation”. Even in the field of psychology/psychiatry, many aetiologies and psychodynamics have been related to the development of psychogenic pain. This article deals with the treatment modalities to deal with the psychological repercussions of physical, orofacial pain.

Evaluation of pain incidence due to venous malformation based on data from 85 institutions in Japan

BackgroundDepending on the size and site of the venous malformation (VM), patients with VM often experience pain and swelling. VMs in the head and neck typically have lower pain rates due to complications than VMs in the limbs and trunk. We evaluated the heuristics on VM pain by statistically analyzing data of patients with VM from a multicenter database in Japan. MethodsWe collected data on age, sex, pain, lesion site, lesion depth, and lesion size for 2199 clinical cases with common VMs. We created categories for lesion depth and size and excluded multiple lesion cases that overlapped in these categories. Next, we constructed cross-tabulation tables to analyze the factors that contributed to pain. Finally, we evaluated the risk of pain in patients with VM by performing binomial logistic regression analysis based on age, sex, lesion site, lesion depth, and lesion size. ResultsFor patients with limb and trunk VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 79%, followed by the skin and subcutis, with an incidence of 43%. For patients with head and neck VMs, the most frequent site of pain was the muscle, tendon, and bone, with an incidence of 28%, followed by the skin and subcutis, with an incidence of 11% (P < .01). For pain incidence by lesion size, pain most frequently occurred in lesions >10 cm (67%), followed by lesions between 5 cm and 10 cm (56%) and lesions <5 cm (29%). ConclusionsOur study indicated a clear order of factors that contributed to pain: lesion site > lesion depth > lesion size. Age was also an important factor. Infants and children had low pain complication frequencies with limb and trunk VMs. As the patients aged, the pain frequency became higher, reaching 50% at almost 7 years of age.

Mitochondrial Dysfunctions in Patients with Migraine

Study Objectives: Migraine is a complex neurovascular disease and is believed to be due to a mixture of genetic and environmental factors. Study design: This was a cross-sectional observational prospective hospital based study conducted on 100 participants. They were divided into two groups; Group A: 50 migrainous patients according to the criteria of the International Classification of Headache Disorders and Group B: 50 healthy subjects both groups were age and sex matched. All subjects underwent a full neurological and psychiatric examination. Full headache evaluation sheet used in headache outpatient clinic in Ain Shams University Hospitals and HIT-6? Headache Impact Test was used. Assay of serum level of N-acetyl-aspartate (NAA) as mitochondrial function marker was done. Results: There was no significant difference between both groups regarding gender, age or age group, marital state, education, residence and special habits. However, there was a statistical significant difference as regards family history of migraine more in patient group. In this study, serum NAA levels in migraine patients were significantly lower than in healthy controls. Decreased NAA level is generally believed to be a sign of reduced neuronal and glial mitochondrial function. Also, migraine with aura patients showed lower NAA levels when compared to migraine without aura subtypes. However, there was no significant correlation was found between NAA serum levels, and gender, age at onset, age group, type of aura, duration of the illness, type of onset of pain, frequent site of pain, time to max severity, severity of attack, and daily functions (social life, work, psychological wellbeing, sleep and cognition). Conclusions: Findings of this study indicate that NAA in serum may be a marker for neuronal dysfunction predisposing to migraine, probably related to the reduced mitochondria function.

Factors associated with the prevalence of back pain and work absence in shipyard workers

BackgroundWe conducted a questionnaire survey of shipyard workers to identify difficulties experienced due to orthopedic or musculoskeletal disorders.MethodsThe subjects were 375 workers (male, 361; female, 14) who worked for a single shipbuilding company. Questionnaire items covered the working environment, including work environment, working posture, and the weight of objects that the subject dealt with, as well as physical and lifestyle characteristics, namely smoking habits, drinking habits, sleeping hours, medications, exercise habits, and any weight gain of 20 kg or more since the age of 20. Subjects were also asked to indicate if they regularly experienced any of 17 listed difficulties in their daily lives, and to use an illustration of the human body to mark any body parts that were painful or hard to move.ResultsThe mean age was 41.8 years (19–73 years). The lower and/or upper back was the most frequent site of pain (46.5%), followed by the shoulders (11.4%), knees (9.6%), and neck (5.3%). Maintaining a half-sitting posture was the most problematic activity of daily living. Back pain was less frequent in subjects who exercised regularly, and more common in those who worked with heavy loads or in narrow spaces. A multinomial logistic regression analysis showed that absence from work was more common in subjects with back pain who had gained weight since their youth, who smoked, who used fire while welding metal, or who worked in a lying posture. While 35.4% of subjects had experienced absence from work due to musculoskeletal pain, only 5.1% were permitted by their employer to alter their work content or reduce their workload.ConclusionsThese results indicate that a large number of shipyard workers have difficulties in their work and daily life activities due to back pain. To prevent worsening of pain and to reduce work absence, it is important to provide appropriate training to minimize the risk factors for back pain that were identified in this study.

Prevalence and incidence of musculoskeletal extremity complaints in children and adolescents. A systematic review

BackgroundIt is difficult to gain an overview of musculoskeletal extremity complaints in childhood although this is essential to develop evidence-based prevention and treatment strategies. The objectives of this systematic review were therefore to describe the prevalence and incidence of musculoskeletal extremity complaints in children and adolescents in both general and clinical populations in relation to age, anatomical site and mode of onset.MethodsMEDLINE and EMBASE were electronically searched; risk of bias was assessed; and data extraction was individually performed by two authors.ResultsIn total, 19 general population studies and three clinical population studies were included with children aged 0-19 years. For most of the analyses, a division between younger children aged 0-12 years, and older children aged 10-19 years was used. Lower extremity complaints were more common than upper extremity complaints regardless of age and type of population, with the most frequent pain site changing from ankle/foot in the youngest to knee in the oldest. There were about twice as many non-traumatic as traumatic complaints in the lower extremities, whereas the opposite relationship was found for the upper extremities in the general population studies. There were relatively more lower extremity complaints in the general population studies than in the clinical population studies. The review showed no pattern of differences in reporting between studies of high and low risk of bias.ConclusionsThis review shows that musculoskeletal complaints are more frequent in the lower extremities than in the upper extremities in childhood, and there are indications of a large amount of non-traumatic low intensity complaints in the population that do not reach threshold for consultation. A meta-analysis, or even a simple overall description of prevalence and incidence of musculoskeletal extremity complaints in children and adolescents was not feasible, due to a large variety in the studies, primarily related to outcome measurements.

Farmers' Cohort for Agricultural Work-Related Musculoskeletal Disorders (FARM) Study: Study Design, Methods, and Baseline Characteristics of Enrolled Subjects.

BackgroundThe ongoing Farmers’ Cohort for Agricultural Work-related Musculoskeletal Disorders (FARM) study was developed to evaluate health status and related factors in farmers.MethodsFarmers in Kangwon Province, South Korea, were recruited. Baseline characteristics were determined using questionnaires about sociodemographic and health characteristics and agricultural work-related factors. In addition, laboratory examinations (lumbar spinal radiography and serologic testing) were conducted.ResultsThe FARM study covers eight rural areas and recruited 1013 subjects (534 women; mean [standard deviation {SD}] age, 57.2 [7.5] years). Musculoskeletal pain in multiple areas was reported by 925 subjects (91.3%), and low back pain (63.8%) was the most frequent site of pain. Farmer’s Stress Inventory (mean [SD], 77.7 [10.2]; range, 28–112] and subjective stress index (mean [SD], 5.3 [2.4]; range, 0–10) were above median scale values, reflecting a stressful condition, while the EuroQol-5D-3L index and the EuroQol-Visual Analog Scale scores were high (mean [SD], 0.9 [0.1]; range −0.171–1 and mean [SD], 67.7 [18.7]; range 0–100, respectively), reflecting good life quality. In total, 53% of participants had worked in farming for more than 30 years, and workers involved in dry-field farming comprised the largest subgroup (41.5%). Most participants (94.3%) had no more than a high school education, and families with annual income below 20 million won constituted the largest subgroup (36.3%).ConclusionsThe FARM study may provide data on the current health status and related sociodemographic and agricultural work-related risk factors in Korean farmers, with the goal of providing a scientific basis for developing coping interventions and preventive strategies.

Une interface pour utilisateur de caméra 3D employée pour enregistrer les angles des poignets lors de prestations au piano

Injuries are common over a performing musician’s career and wrist injuries are the most frequent site of pain for pianists. Although general recommendations insist on keeping wrists in a “neutral” position to avoid injury, this is rarely done in practice. Recent advances in motion capture technology may aid in raising students’ awareness of the propensity to use wrist positions outside of the recommended “neutral.” These technologies may be used to measure precise wrist positions in piano playing in order to set specific thresholds for avoiding injury. This paper discusses various advantages and limitations of motion capture technologies, including data visualization and usage within the music instrument pedagogy framework in order to define a set of requirements for an accessible motion-tracking system. A prototype of a dedicated image-processing-based system with a graphical user interface that meets these requirements is described. This system uses passive coloured markers and a standard 3D camera, encouraging use outside the traditional laboratory environment. Simple camera calibration options and basic hand tracking from aerial view images allow monitoring of wrist flexion/extension over short video recordings. Measurements are compared to flexion/extension thresholds recommended for typists to prevent carpal tunnel pressure, and moments of approaching or exceeding these thresholds are flagged to the user both in real time and in post-performance. Potential applications include monitoring the practice of short technical passages without restriction of instrument or location.

Influence of body posture on the association between postpartum depression and pain.

To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium. Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: literate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation. There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001). The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent.

Diagnosis of Growing Pain in Bangladeshi Pediatric Population

Background: Unexplained limb pain is a major diagnostic challenge. Parents become very much worried as their physician are not sure regarding accurate diagnosis of unexplained limb pain. Majority of the limb pain are due to Growing pain which can be diagnosed by using Standard Criteria. Objectives: The purpose of the present study was to see the clinical aspects of growing pain and to determine the causes of unexplained limb pain. Methodology: This study prospectively examined the presence of growing pain in a self reported population of children with limb pain of unexplained etiology attending National Center for Control of Rheumatic Fever and Heart Disease over the period of 6 months. Results: Total 57 children of 3-12 yrs of age were enrolled in this study and out of them 43(75.4%) were diagnosed as Growing Pain. Mean age of growing pain was 7.77(2.66). 19 children (44.2%) were male and 24 (55.8%) were female. Most frequent site of pain was calf (65.1%) and 95% cases pain occur at night. Growing Pain usually occur at slow growing period (86%) than rapid growing period (14%). Conclusion: Majority of unexplained limb pain are growing pain which is benign. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16251 J Shaheed Suhrawardy Med Coll, 2013;5(1):46-48

Inadequate pain relief in ambulatory patients with human immunodeficiency virus disease in Port Harcourt

ObjectivesTo estimate the prevalence of pain in ambulatory patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Port Harcourt and to determine the type, site, severity, and adequacy of the treatment of pain in these patients.Materials and methodsA cross-sectional survey was carried out at two antiretroviral therapy centers in Port Harcourt, Nigeria. A data sheet, the brief pain inventory, and the short form of the McGill pain questionnaire were used and 157 patients in various stages of HIV/AIDS participated in the study.ResultsAbout 83.7% (129/157) of the ambulatory patients with HIV/AIDS complained of pains. Of the patients who reported pain 61.24% (79/129) reported nociceptive pain while 38.76% (50/129) reported neuropathic pain. Chest pain was the most frequent site of pain followed by headache. About 82% (106/129) of those who complained of pain received some form of analgesic, but only 23.58% (25/106) of these obtained adequate pain relief. The majority of the participants had significant impairment of their quality of life due to the severity of their pain.ConclusionPain associated with significant impairment of quality of life is common in ambulatory patients with HIV/AIDS in Port Harcourt. Whereas the majority of the patients used various pain relief methods, analgesia was inadequate.

Pain in primary care: an Italian survey

Pain is a universal symptom of various pathologies and largely affects human well-being. Pain is therefore commonly observed by general practitioners (GPs) and its management is a useful indicator of quality. In our study we investigated the epidemiology and management of pain in Italian general practice. Participating GPs were asked to record the first out of every two contacts with pain during two working weeks between November 2000 and February 2001. They entered information on type of pain, pain-related diagnosis, certainty of diagnosis and types of prescription. 89 GPs participated in the study. About one third of all reported contacts were with pain. The number of contacts analysed was 1432. Nearly half the cases were diagnosed as acute. The main complaints were of musculoskeletal and abdominal origin. Pain was 1.5 times more frequent in women than men and the female to male ratios for acute and chronic pain were 1.2:1 and 1.8:1 respectively. The most frequent site of pain was the limbs. 'Arthropathies and related disorders', 'dorsopathies' and 'rheumatism excluding the back' were the commonest groups of diagnoses. Approximately two thirds of contacts with pain led to a drug prescription. The study identified a high proportion of contacts with pain in Italian general practice, with widespread use of drugs. The distribution of chronic and acute pain was rather similar and musculoskeletal pain was the most frequent form. Most types of prescriptions were closely related to certainty of diagnosis.

Chronic Pain in Persons With Neuromuscular Disease

Jensen MP, Abresch RT, Carter GT, McDonald CM. Chronic pain in persons with neuromuscular disease. Arch Phys Med Rehabil 2005;86:1155–63. Objective To examine the nature and scope of pain in persons with neuromuscular disorder (NMD). Design Survey study. Setting University-based rehabilitation research programs. Participants Adults with NMD (N=193). Interventions Not applicable. Main Outcome Measures Pain presence or absence, pain severity, pain quality (Neuropathic Pain Scale), pain interference (Brief Pain Inventory), pain site, quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36]), and pain treatment. Results Seventy-three percent of the sample reported pain, with 27% of these reporting that this pain was severe (≥7 on a 0–10 scale), on average. “Deep,” “tiring,” “sharp,” and “dull” were the words used most frequently to describe NMD pain. Patients with amyotrophic lateral sclerosis and myotonic muscular dystrophies reported the greatest pain interference, and patients with Charcot-Marie-Tooth the least, among all NMD diagnoses. The most frequent pain site, overall, was back (49%), followed by leg (47%), shoulder (43%), neck (40%), buttock and hip(s) (37%), feet (36%), arm(s) (36%), and hand(s) (35%). The study participants reported significantly greater dysfunction than subjects in the SF-36 normative sample (persons without health problems) on a number of the SF-36 scales. However, we found no significant differences between the study participants and the US norms on the SF-36 role-emotional or mental health scales. A number of pain treatments were used by the study sample, but no treatment appeared to be effective for all participants, and some of the treatments reported as most effective (eg, chiropractic care) were used by very few participants. Conclusions Pain is a common problem among patients with NMDs. There are many similarities, but also some important differences, between NMD diagnostic groups on the nature and scope of pain and its impact. More research is needed to identify and test effective treatments for NMD-related pain.