Pain Intensity Research Articles

Stones Unearthed: A Journey to Wellness with Ayurvedic Urolithiasis (Mutraashmasri) Management

Urolithiasis is a prevalent clinical condition impacting over 10% of the population in industrialized nations, causing symptoms like intense renal pain, lower abdominal discomfort, painful urination, and cloudy or foul-smelling urine. Despite various medical treatments, managing renal calculi proves financially burdensome, with recurrent stone formation posing a persistent challenge. Ayurvedic diagnostics, including assessing individual constitution (Prakriti), urine (Mutra), and pulse (Nadi), lay the foundation for understanding Mutraashmari causes. Renal calculi are closely linked to Agni (digestive fire) imbalances and the accumulation of Ama (toxins). Ayurvedic interventions aim to enhance Agni, eliminate Ama, and restore Doshic equilibrium, encompassing dietary changes, lifestyle adjustments, and herbal formulations. This case report presents a 45-year-old male with renal calculi (7.7mm at ureteropelvic junction and 7.4mm at ureter-bladder junction) experiencing severe pain, backache, hematuria, and recurrent urinary tract infections. After ineffective allopathic treatment, the patient sought Ayurvedic care, achieving complete urolithiasis dissolution within one month.

Similarities and Differences in Resting-State Brain Activity Changes of Distinct Chronic Pain Types.

To explore neural similarities and differences between visceral and somatic pain by comparing spontaneous brain activity in patients with chronic temporomandibular disorder (TMD) and irritable bowel syndrome (IBS). Twenty eight IBS patients, 21 TMD patients, and 28 healthy controls (HC) underwent resting-state fMRI and behavioral assessments. The correlations between fMRI metrics such as the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), functional connectivity (FC), and clinical manifestations were further analyzed. Compared with HC, both patient groups demonstrated increased ALFF in right parahippocampal gyrus (PHG), insula, medial superior frontal gyrus (SFGmed), precentral gyrus (PreCG), and increased ReHo in right SFGmed and left supplementary motor area (SMA). Compared with IBS patients, TMD patients exhibited reduced ALFF in right SFGmed and insula, increased ALFF in right PHG and PreCG, decreased ReHo in right SFGmed and left lingual gyrus, and increased ReHo in left SMA. Both patient groups exhibited enhanced right PHG-related FC in left precuneus and right cingulate gyrus, and right insula-related FC in left superior temporal gyrus and right paracentral lobule. Specifically, IBS patients showed higher FC between right PHG and orbitofrontal cortex than TMD patients, which was negatively correlated with mood and gastrointestinal symptoms. Mediation analysis revealed that pain in TMD and gastrointestinal symptoms in IBS mediated these relationships. Visceral and somatic pain share abnormal activity in multiple brain networks. Abnormalities in affective region present potential neuroimaging markers for pain disorders, with depression in somatic pain linked to pain intensity and in visceral pain to gastrointestinal symptoms.

Systematic review and meta-analysis of conventional medical management in a patient population with refractory chronic pain suitable to receive a spinal cord stimulation system.

The aim of this review was to systematically identify all evidence that used conventional medical management (CMM) as a comparator in randomised controlled trials (RCTs) of spinal cord stimulation (SCS) therapy, and to conduct a meta-analysis to investigate if continued CMM provides statistical or clinically meaningful pain relief and whether CMM effects have improved over the last few decades. Databases were searched from inception to June 2024 for RCTs that compared SCS to CMM. The primary outcome of the review was absolute change in pain intensity from baseline to the last available follow-up in the CMM group, measured using a visual analogue scale or numerical rating scale. The measure of treatment effect for absolute change and percentage change in pain intensity from baseline was mean difference (MD) and 95% confidence interval (CI). Risk of bias (RoB) was assessed by using the revised Cochrane RoB tool. The protocol for this review is registered on PROSPERO (CRD42023449215). Meta-analysis of absolute change in pain intensity from baseline to last follow-up shows that CMM is not associated with any significant reductions in pain intensity (MD -0.11; 95% CI: -0.32 to 0.11; moderate certainty). Similar results were observed for percent change in pain intensity from baseline to last follow-up (MD -3.22%; 95% CI: -12.59% to 6.14%; moderate certainty). No significant differences were observed when considering decade of publication of the RCT for absolute (p = 0.065; moderate certainty) or percent change in pain intensity (p = 0.524; moderate certainty). Meta-analysis for 6-month follow-up and sensitivity analysis shows similar numerical results. Our findings show that continued CMM for a population eligible for SCS does not provide meaningful pain relief and has not considerably changed over the last few decades. The use of CMM as the control to evaluate relative SCS treatment effects should be reassessed.

Chronic lower back pain among occupational workers: effect of relaxation technique on quality of working life, pain and disability level with nurse-led intervention

BackgroundLower back pain (LBP) is the main cause of workplace impairment and a significant contributor to absenteeism. Implementing relaxation techniques in the workplace can be considered an investment because it can eventually lower the incidence of chronic LBP (chronic lower back pain).AimThe purpose of the current study was to evaluate the effect of relaxation techniques on the quality of working life, pain and disability level, with nurse-led interventions among occupational workers with chronic lower back pain (CLBP).MethodA quasi-experimental design with a pre- and post-test method was used.SettingThe study took place at a yarn and textile factory in Kafr El-Sheikh City, Kafr El-Sheikh Governorate, Egypt.SampleA purposive sample of 100 industrial workers with persistent LBP was chosen. The participants were matched and sorted into two equal groups: the study group and the control group.InstrumentsThe study used a structured interview questionnaire, the Visual Analogue Scale (VAS), the Quality of Working Life Scale (QWL), and the Oswestry Disability Index.ResultsParticipants’ average age was 41.4 ± 8.7 years in the study group and 40.5 ± 7.8 years in the control group. Following the relaxation technique intervention, the study group’s pain intensity, frequency, and duration were significantly lower than in the control group. Following the intervention, the study group’s overall quality of working life improved statistically significantly, with the mean score rising from 72% in the pretest to 93.3% in the post-test. The research group’s daily activities and the overall quality of working life improved dramatically when compared to the control group. Furthermore, after the intervention, the study group’s disability levels decreased significantly, with only 46% having a disability compared to 86% before the intervention.ConclusionsThe implementation of relaxation techniques greatly improved the quality of working life in the study group when compared to the control group. There was a notable and statistically significant difference in pain intensity between the study group and the controls. Following the intervention, industrial workers’ daily living activities improved, despite persistent LBP.RecommendationHealth education and awareness programs should be conducted to improve the quality of life for industrial workers with LBP. Additionally, occupational health nurses’ roles in the early detection and referral of LBP patients in diverse industrial settings should be strengthened.

Efektivitas Pijat Endorphin Dan Countour Presure Terhadap Nyeri Persalinan Di Klinik Annisa

Introduction: Labor pain is a physiological process, which occurs due to contractions due to internal hormonal processes childbirth such as increased oxytocin levels, increased prostaglandin levels and decreased progesterone levels. Efforts that can be applied to reduce labor pain in the first stage are non-pharmacological methods, one of which is endorphin massage and counter pressure. Objective: To determine the effectiveness of endorphin massage and counter pressure on the intensity of labor pain in the active phase of the first stage. Method: Using a before and after quasi-experimental design with 30 respondents divided randomly into two groups, namely group A received endorphin massage therapy, group B received countour pressure massage therapy. Results: Between the two groups, the normality value tested with the Shapiro Wilk showed a p- value>0.05 and the parametric statistical test paired T Test showed a p-value <0.05. Conclusion: giving endorphin massage and countour pressure has been proven to be able to reduce the intensity of labor pain during the first active phase. Keywords: Endorphin, Countour Pressure, Labor Pain

Comparative Analysis of SCM Muscle Fatigue in Office Workers with Hunched Posture: A Study on Chronic Lower Back Pain versus Non-Affected Individuals.

This study examines the disparities between people suffering from chronic lower back pain (LBP) and those who do not, with a particular focus on how extended periods of sitting with poor posture affect fatigue and discomfort in the sternocleidomastoid (SCM) muscles among office employees. Eighty university staff and students were enrolled in the study by matching age, BMI, and type of job. They were split into two groups later: a control group (n = 40) with no back pain and a pain group (n = 40) with a history of lower back pain (LBP). Pain intensity was measured using a Visual Analog Scale (VAS), while SCM muscle activity was measured via surface electromyography (sEMG) during both normal and hunched postures. Participants maintained each posture for a specified duration of 30min. The study revealed that Pain_Hunched group exhibited significantly reduced SCM muscle activity compared to the Control_Hunched group (mean difference = -9.728, p < 0.001). Furthermore, the SCM muscle activity in the Pain_Hunched group was significantly lower than that of the Pain_Normal group (mean difference = -2.769, p = 0.041). These results highlight the heightened SCM muscle activity during hunched postures, particularly in individuals with LBP. The results emphasize the crucial role posture plays in influencing SCM muscle activation and pain perception among individuals with LBP. These results imply that correcting one's posture could be a useful pain management intervention technique for this population. The long-term impacts of postural adjustments and their possible advantages in clinical contexts, such as incorporating ergonomic interventions or specific exercise regimens, should be investigated in future studies.

AI-Assisted Physiotherapy for Patients with Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis

Background: Non-specific low back pain (LBP) is a widespread condition with significant impacts on physical activity, muscle strength, psychological well-being, and economic status. Traditional physiotherapy shows variable efficacy, prompting growing interest in AI-assisted physiotherapy for its potential to offer personalized feedback and multidisciplinary care integration. Objective: This systematic review and meta-analysis aimed to evaluate AI-assisted physiotherapy’s effectiveness in reducing pain intensity and functional impairment and improving mental health compared to usual physiotherapy. Method: A comprehensive search strategy was employed across Embase, MEDLINE, Cochrane Library, and Web of Science databases from inception to 30 May 2024. Comparative studies were identified and screened using PICOS criteria. Data extraction involved detailed study characteristics and outcomes, with methodological quality assessed via the Cochrane Risk of Bias tool. Meta-analyses using random-effects models calculated standardized mean differences (SMDs). Results: Eight studies met the inclusion criteria. Compared to usual physiotherapy, AI-assisted physiotherapy did not demonstrate any statistically significant differences in outcomes across the aspects studied, including pain intensity (SMD = −0.2711, 95% CI: −0.5109 to −0.0313, p = 0.267), functional impairment (SMD = −0.2508, 95% CI: −0.5574 to 0.0559, p = 0.1089), and mental health (SMD = −0.0328, 95% CI: −0.1972 to 0.1316, p = 0.6956). These findings indicate that AI-assisted physiotherapy had no demonstrable additional effect compared to usual physiotherapy for patients with LBP. Sensitivity analyses were conducted to address inter-study heterogeneity, confirming the robustness of these results. Conclusions: While AI-assisted physiotherapy shows potential in managing LBP by providing personalized treatment and feedback, the current evidence does not demonstrate significant advantages over usual physiotherapy. Further large-scale, long-term, and methodologically rigorous randomized controlled trials are necessary to validate these findings, assess their clinical relevance, and explore broader public health applications.

Duodenal obstruction after non-endoscopic intragastric balloon placement: a rare but severe complication.

We report the case of a mid-30s woman with no prior medical history who presented to the emergency department with intense upper abdominal pain lasting 12 hours. She had undergone the placement of a non-endoscopic, swallowed intragastric balloon the day before. Physical examination revealed significant tenderness in the upper abdomen without signs of peritoneal irritation. Abdominal computed tomography showed a 12-cm balloon lodged in the duodenum with peritoneal effusion but no evidence of free perforation.

The effect of adding hip strengthening exercises to lumbar stabilizing exercises on gait for the treatment of non-specific low back pain: a randomized controlled trial

IntroductionTo evaluate the impact of adding hip strength exercises to lumbar stabilizing exercises on pain, disability, and spatio-temporal parameters of gait in the treatment of non-specific low back pain (NSLBP).MethodsIn this randomized controlled trial, 60 patients diagnosed with NSLBP were randomized into two equal groups. The subjects were randomly allocated to either group A, the control group (&lt;i&gt;n&lt;/i&gt; = 30), performing lumbar stabilizing exercises, or group B, the study group (&lt;i&gt;n&lt;/i&gt; = 30), receiving lumbar stabilizing exercises and a progressive hip strengthening exercise program. The frequency of intervention was 3 sessions per week for six weeks. In this trial, the Visual Analogue Scale for pain intensity, Modified Oswestry Disability Index for disability, and Kinovea 2D motion analysis for spatio-temporal parameters were evaluated pre-treatment and after six weeks.ResultsThere were statistically significant differences between groups in changes in pain scores (&lt;i&gt;p&lt;/i&gt; = 0.035), the disability index (&lt;i&gt;p&lt;/i&gt; = 0.012), and COG vertical displacement (&lt;i&gt;p&lt;/i&gt; = 0.017). There were no statistically significant differences in stride length, stride time, stride speed, or cadence between the control and study groups (&lt;i&gt;p&lt;/i&gt; &gt; 0.005).ConclusionsAdding hip strengthening exercises to a lumbar stabilization exercise program can reduce pain and disability and decrease COG vertical displacement more than a lumbar stabilization exercise program alone in NSLBP patients. However, no differences were found in gait speed, cadence, stride length, and stride time.

Relationship Between Preoperative Fasting Duration and Anxiety Levels With Postoperative Pain, Nausea-Vomiting, and Sleep Quality in Orthopedic Surgical Patients: A Cross-Sectional Study.

This study is a cross-sectional study aimed to determine the association between preoperative fasting time and anxiety level and early postoperative pain intensity, nausea-vomiting severity, and sleep quality in patients undergoing orthopedic surgery. The study was conducted between March and June 2024 and completed with 188 patients. In the study, patient information form, Amsterdam Preoperative Anxiety and Information Scale, and Richards-Campbell Sleep Questionnaire were used. Correlation analysis indicated a significant negative correlation between postoperative sleep quality and pain intensity. There was a significant positive correlation between preoperative anxiety level and preoperative solid food fasting and fluid fasting times. According to the multiple linear regression model, preoperative anxiety level was found to have a significant effect on pain severity, and pain severity at the postoperative 24th hour significantly affected postoperative sleep quality. Adjusting patients' fasting durations prior to surgical interventions according to evidence-based guideline recommendations and monitoring anxiety closely are simple, practical, and safe measures that could alleviate postoperative pain and nausea-vomiting and improve sleep quality, potentially enhancing outcomes, comfort, and the quality of care.

Sleep, Pain Catastrophizing, and Pain Intensity in Treatment Seeking Adults With Opioid Use Disorder.

Opioid use disorder (OUD) is a large, growing, and difficult-to-treat problem. It has been associated with poor sleep, which has a relationship of mutual exacerbation with pain. These interrelationships have prompted interest in how pain catastrophizing (pain-related distortions of cognition), interacts with pain and sleep quality and quantity in those with OUD. Participants with chronic pain and OUD (N = 105) completed a battery of self-report assessments. A subset of these participants (N = 63) wore an actigraphy watch for 2 weeks. Six mediation models were evaluated in this cross-sectional study interrelating pain intensity, pain catastrophizing, and sleep in previously published work were run 3 times each, measuring global sleep quality through the Pittsburgh Sleep Quality Index, self-reported total sleep time (TST) through Pittsburgh Sleep Quality Index, and objective TST through actigraphy. Three models yielded statistically significant results: (1) the relationship between global sleep quality and pain intensity mediated by pain catastrophizing (z = -2.00, P = 0.045), (2) the relationship between objective TST and pain intensity mediated by pain catastrophizing (z = -2.15, P = 0.032), and (3) the relationship between pain intensity and objective TST mediated by pain catastrophizing (z = -2.36, P = 0.018). Pain catastrophizing is a significant mediator of the relationship between the mutually exacerbating factors of sleep quality and pain intensity, and is, therefore, an important treatment target in this population. In addition, objective TST and self-reported TST were only moderately correlated and behaved differently in mediation models, suggesting that more research is needed to understand the relationship between perceived sleep quality and sleep quantity.

Race and gender biases in assessing pain intensity and medication needs among Chinese observers.

Pain-related decision-making can be influenced by the caregiver and sufferer's demographic factors, such as race and gender, which are commonly considered individually. However, such factors may influence pain assessment interdependently based on caregivers' stereotypical beliefs. This study investigated how sufferers' race and gender affect Chinese observers' evaluations of pain intensity and medication needs and the associations with the observers' race and gender-related stereotypical beliefs. One hundred sixty-two Chinese participants completed a pain facial expression rating task assessing the level of pain intensity and the extent to which they believe the sufferer needs pain medication for East Asian, White, and Black sufferers, followed by a battery of questionnaires measuring their gender and race role expectation of pain. Chinese observers were more stringent on East Asians' pain intensity and needs for medication than Whites and Blacks'. However, when Black and East Asian sufferers were perceived to have a similar level of pain, East Asians were more likely to receive medication than Blacks, which is partly due to the observers' stereotypical beliefs that Blacks would have a speedier recovery than East Asians. Our results provided evidence that in addition to the in-versus-out-group preferences, one's sociocultural-related stereotypical beliefs can account for racial disparities in pain-related decision-making.

Differences in Emotional Awareness Moderate Cytokine-Symptom Associations Among Breast Cancer Survivors.

Cancer survivors have elevated levels of proinflammatory cytokines, which could be associated with cancer-related symptoms. Given that proinflammatory cytokines heighten negative affect by directly affecting the brain, we explored these direct associations and whether differences in levels of emotional awareness moderate the associations between proinflammatory cytokines and cancer-related symptoms. This cross-sectional, secondary analysis of baseline data was collected from 162 female breast cancer survivors (aged 36-70years), who were enrolled 6±4 months after completing cancer treatment. We tested cytokines in serum (IL-1β, IL-6, IL-8, TNF-α, IL-4, IL-10, and TGF-β) and assessed depression, cancer-related fatigue, pain intensity, and pain interference. Emotional awareness was assessed using a performance measure, the Levels of Emotional Awareness Scale. In participants with high but not average or low levels of emotional awareness, positive associations were found for IL-1β, IL-6, and TNF-α with depression and between IL-6 and TNF-α with pain intensity. In addition, IL-6 had a positive association with pain intensity at average levels of emotional awareness. These results suggest that women with high or in some cases average, but not low, emotional awareness reported depression and pain as being positively associated with their cytokine levels. By using emotional awareness as a cognitive resource to promote emotion regulation and distress transformation, interventions may be able to counteract heightened sensitivity to the mood-altering effects of cytokines.

The Impact of Acupuncture on Pain Intensity, Nausea, and Vomiting for Laparoscopic Cholecystectomy: A Meta-analysis Study.

Acupuncture may have some potential in pain relief after laparoscopic cholecystectomy, and this meta-analysis aims to explore the impact of acupuncture on pain intensity, nausea and vomiting for patients undergoing laparoscopic cholecystectomy. PubMed, EMbase, Web of science, EBSCO, Cochrane library databases, CNKI, VIP, and Wangfang were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of acupuncture on pain control for laparoscopic cholecystectomy. Five RCTs and 366 patients were included in the meta-analysis. Overall, compared with control intervention for laparoscopic cholecystectomy, acupuncture was associated with significantly reduced pain scores at 6 hours [mean difference (MD)=-0.86; 95% CI=-1.37 to -0.34; P =0.001, 2 RCTs) and pain scores at 8 to 10 hours (MD=-0.71; 95% CI=-1.13 to -0.28; P =0.001, 2 RCTs), decreased incidence of nausea (odds ratio=0.10; 95% CI=0.03-0.34; P =0.0003, 3 RCTs), and vomiting (odds ratio=0.11; 95% CI=0.01-0.85; P =0.03, 3 RCTs), but demonstrated no obvious impact on pain scores at 12 to 24 hours (MD=-0.38; 95% CI=-1.02 to 0.27; P =0.25, 2 RCTs). Acupuncture may be effective to reduce pain intensity, nausea, and vomiting for laparoscopic cholecystectomy.

Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms.

Fibromyalgia has a high female predominance and research work has been focussing mainly on women. We aimed to answer (1) gender differences in pain scores and quality of life, (2) any gender-specific subgroups defined by quantitative sensory testing (QST), and (3) correlations of QST parameters with pain intensity and questionnaire scores. We evaluated clinical presentations and QST profiles from 38 male and 38 age-matched female patients. Women reported significantly higher scores in average daily pain, daily sleep interference score, average weekly pain, weekly sleep interference score, and revised fibromyalgia impact questionnaire (rFIQ). Based on LOGA classification, L0G2, mechanical allodynia or hyperalgesia without abnormal sensory loss, was the most common QST subtype which accounted for 28.9% of men and 26.3% of women. Approximately 34.2% of men and 26.3% of women displayed loss of function of small fibres with an increased cold or warm detection threshold. Cold detection threshold was negatively correlated with pain intensity and functional impairment, suggesting a peripheral mechanism. Central sensitization, defined as allodynia and hyperalgesia to thermal or mechanical stimuli, was found in two-thirds of male and female patients. Mechanical pain sensitivity was positively correlated with the severity of pain and associated symptoms in women, but not men. There was a marked gender difference in reported pain and quality of life. We have confirmed that central sensitization is a major mechanism for women. Our data suggested an important role of small fibre pathology in both men and women.

Are Tailored Interventions to Modifiable Psychosocial Risk Factors Effective in Reducing Pain Intensity and Disability in Low Back Pain? A Systematic Review with Meta-Analysis of Randomized Trials.

OBJECTIVE: To determine whether tailored interventions based on patients' psychological profiles enhanced the outcomes of interventions in people with nonspecific low back pain, compared to usual care. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: Embase, Cochrane, Medline, Web of Science, CINAHL, and PsycINFO were searched from their inception until November 2, 2023. STUDY SELECTION CRITERIA: We included randomized clinical trials that compared psychological interventions to any alternatives without psychological components in patients with nonspecific low back pain who were stratified based on their psychological risk factors using the cutoff of the questionnaires measuring a psychological construct. DATA SYNTHESIS: The outcomes were pain intensity and disability. The revised Cochrane risk-of-bias tool for randomized trials was used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to judge certainty of evidence. RESULTS: Twenty-nine trials were included, most presenting some concerns for the risk of bias. The certainty of evidence was mostly low, with moderate to substantial heterogeneity. Using psychological stratification, individuals who received a psychological intervention (versus usual care) reported lower pain intensity at the short term (MD, -0.22; 95% confidence interval [CI]: -0.41, -0.02) and midterm (MD, -0.37; 95% CI: -0.57, -0.16). For disability, there was a larger improvement with psychological interventions versus usual care at short-term (SMD, -0.17; 95% CI: -0.32, -0.02), midterm (SMD, -0.16; 95% CI: -0.28, -0.05), and long-term (SMD, -0.17; 95% CI: -0.29, -0.04) follow-ups. CONCLUSIONS: Psychological interventions had a positive impact, although small, on reducing pain intensity and disability in patients with low back pain and psychological risk factors. J Orthop Sports Phys Ther 2025;55(2):1-20. Epub 3 January 2025. doi:10.2519/jospt.2025.12777.

OVERVIEW OF PAIN IN UKRAINIAN WAR INJURED

Our objective is to study the relationship between armed conflict injuries and pain and the treatments that have been applied to Ukrainian injured soldiers in our hospital. We performed an observational study of a sample of 91 injured soldiers. The metrics we selected for the study included time from injury, length of stay, diagnosis, treatment, type and intensity of pain and questionnaires about pain and quality of life for the group of amputees. The statistical study was carried out using SPSS v.30. 85 % of the 91 patients suffered from pain in at least one part of their body. 53 patients experienced neuropathic pain, 15 patients had somatic pain and 29 patients had a combination of both. The average pain intensity was 6 points in the Visual Analogue Scale (VAS) and 5 points in the DN-4 scale. The most common treatments for neuropathic pain were neuromodulators, nerve blocks, capsaicin patches and TMR (targeted muscle reinnervation). The study of injuries caused in current armed conflicts can help us anticipate complications and understand and treat pain early to improve the independence of patients, especially of amputee patients.

Co-occurrence of mental distress and insomnia associates with more severe musculoskeletal pain - Northern Finland Birth Cohort 1966 study.

This cross-sectional study demonstrates the differences in the dimensions of musculoskeletal (MSK) pain between participants with mental distress and/or insomnia among general population with MSK pain within the past 12months. Participants of Northern Finland Birth Cohort 1966 (NFBC1966) were studied (n=4316). They were divided into groups based on their mental distress and insomnia status (co-occurring mental distress and insomnia [CMI], isolated mental distress [M] and insomnia [I], and absence of both [AMI]). The AMI group was used as a reference for the main analyses. The dimensions of MSK pain included frequency, bothersomeness (Numerical Rating Scale [NRS] 0-10), intensity of pain (NRS), and number of pain sites (1-8). Multinomial and general linear regression analyses were used to study the associations, and adjustments were made for sex, education, number of somatic diseases, and physical activity. The CMI group was associated with more severe pain in every dimension when contrasted to all other groups (daily pain adjusted OR 5.08, 95% CI 3.43-7.51; bothersomeness adjusted β 1.7, 95% CI 1.5-2.0; intensity adjusted β 1.4, 95% CI 1.2-1.7; number of pain sites adjusted β 1.2, 95% CI 1.0-1.4). Compared to AMI, I and M groups also had relationships with all pain dimensions, but with lower magnitude compared to the CMI group. The results suggest that insomnia and mental distress co-exist with more severe MSK pain, and when co-occurring, MSK pain severity tends to increase. Therefore, contemplating insomnia and mental distress are important to consider when comprehensively evaluating MSK pain symptoms.

Differences on lower trapezius pressure pain threshold, muscle strength and muscle thickness in individuals with chronic neck pain and active or latent myofascial triggers points.

Myofascial trigger points (MTrPs) in the lower trapezius have been recognized as an important source of neck pain. This study aims to compare the lower trapezius muscle strength, pressure pain threshold (PPT) and muscle thickness at rest and contraction between participants and painful vs. no-painful side with active and latent MTrPs; and to examine the associations among these variables with pain intensity, duration and disability in patients with neck pain. A cross-sectional study was carried out in 64 people with neck pain with active or latent MTrPs (34 Active MTrPs group and 30 Latent MTrPs groups). Muscle strength, pressure pain threshold and muscle thickness at rest and contraction of the lower trapezius was recorded. No significant differences were found in descriptive data, dominant side, or side of neck pain. However, the Active MTrPs Group had lower pain pressure thresholds (PPT) on the neck pain side compared to the Latent MTrPs Group, indicating greater sensitivity. Muscle thickness and strength showed minor differences between groups. Pain intensity correlated moderately with pain duration and strongly with neck pain disability. The results of the present study showed differences in PPT on the lower trapezius muscle in active and latent MTrP in neck side pain compared to non-neck side pain. In addition, lower trapezius strength reported differences between the neck side pain compared to non-neck side pain in both active and latent MTrP. Lower trapezius muscle strength showed significant moderate association with muscle thickness at contraction.

Applying evidence-based cross-disciplinary concepts helps to explain the heterogeneity in pain, function, and biological measures in individuals with knee pain with/at risk of osteoarthritis.

Factors contributing to individual differences in knee osteoarthritis remain elusive. Dispositional traits and socioeconomic status are independent predictors of mental and physical health, although significant variability remains. Dispositional traits serve as the biological interface for life experiences. We investigate group differences based on dispositional traits and poverty status, specific to (1) pain intensity and functional limitations and (2) biological measures, a clinical composite and brain age. Adults aged 45 to 85 years with knee pain associated with chronic musculoskeletal pain provided information on demographics, socioeconomic and psychosocial factors, pain, and physical function. Kellgren-Lawrence scores were determined from knee radiographs, the clinical composite from fasting blood draws, and brain age from MRI data. One hundred seventy-three individuals participated in the study. Of those, 117 had protective dispositional traits (81 above poverty/36 in poverty), and 56 had vulnerable dispositional traits (24 above poverty/32 in poverty). With sex, study site, Kellgren-Lawrence score, and age/or image quality as covariates, significant group differences were observed across clinical pain (P < 0.001), functional limitations (P ≤ 0.001), and brain age (P ≤ 0.002) measures. Although not significant, the clinical composite measure aligned with the other outcome measures and demonstrated the hormesis inverted U pattern. Groups based on dispositional traits and socioeconomic status explain differing clinical outcomes. Consistent with the allostatic load and hormesis inverted U models, one group was in an adaptive health status, 2 groups were showing signs of developing load, and the fourth group showing signs of overload, at risk of worse health outcomes.