Lower Pain Intensity Research Articles

BIDIRECTIONAL LINKS OF DAILY SLEEP QUALITY AND DURATION WITH PAIN AND SELF-RATED HEALTH IN OLD AGE

Abstract Sleep and physical well-being (e.g., pain, self-rated health) are closely linked, but the temporal ordering, especially regarding day-to-day variations, is not well understood. Furthermore, sleep quality and duration are only moderately correlated and may differ in their association with physical wellbeing. Using data from 123 young-old (66-69 years, 47% women) and 47 old-old adults (84-90 years, 60% women) who rated sleep quality and duration as well as pain and self-rated health on seven consecutive days, we examined bidirectional links between sleep and physical well-being. Supporting our hypotheses, results showed that after longer and better than usual sleep, participants reported better self-rated health; only better sleep quality significantly predicted lower pain. In turn, both lower pain intensity and increased self-rated health predicted better subsequent sleep quality, but not duration. We discuss conceptual and practical implications of our findings.

Literature Review: Teknik Menurunkan Intensitas Nyeri pada Ibu Bersalin

Labor pain is a type of labor pain that varies in intensity depending on the person. This pain is frequently regarded by the mother as the most severe pain she has ever felt. The goal of this study is to study into some related literature to minimize the intensity of labor searching. The strategy used in this study was metadata analysis combined with a literature evaluation to lower labor pain intensity. There are 14 research publications that are in accordance with this research, based on various studies that have been conducted. Based on the findings, it has been shown that non-pharmacological treatment can reduced the intensity of discomfort experienced by laboring mothers more convenient to do either health workers or patient companions is Birth Ball technique, massaging the lower back and taking deep breaths during contractions. The findings of this study can be utilized as a guide when offering non-pharmacological treatment to mothers who are experiencing severe labor pain.

Literature Review: Teknik Menurunkan Intensitas Nyeri pada Ibu Bersalin

Labor pain is a type of labor pain that varies in intensity depending on the person. This pain is frequently regarded by the mother as the most severe pain she has ever felt. The goal of this study is to study into some related literature to minimize the intensity of labor searching. The strategy used in this study was metadata analysis combined with a literature evaluation to lower labor pain intensity. There are 14 research publications that are in accordance with this research, based on various studies that have been conducted. Based on the findings, it has been shown that non-pharmacological treatment can reduced the intensity of discomfort experienced by laboring mothers more convenient to do either health workers or patient companions is Birth Ball technique, massaging the lower back and taking deep breaths during contractions. The findings of this study can be utilized as a guide when offering non-pharmacological treatment to mothers who are experiencing severe labor pain.

Musculoskeletal Pain Among Community-Dwelling Older Adults during the COVID-19 Pandemic: A Longitudinal Survey

OBJECTIVE: To describe the MSK pain prevalence and incidence and identify factors associated with MSK pain among older adults over a 1-year follow-up during the COVID-19 pandemic. METHODS: This longitudinal telesurvey recruited community-dwelling older adults (less than or equal to 65 years) in Hamilton, Canada. MSK pain prevalence and incidence were calculated. Multilevel negative binomial and ordered logistic regression models were used to identify factors associated with the number of pain sites (0 to 7 pain sites), and most intense pain (no, mild, moderate, and severe pain). RESULTS: We included 247 participants. Pain prevalence ranged between 64% at baseline to 73% at one year. The interaction of mental health by time as well as age and mobility were associated with the number of pain sites. Being older (IRR 0.96; 95% CI 0.94 to 0.98) and having better mobility (IRR 0.96; 0.95 to 0.96) were associated with lower number of pain sites. Having better mental health was associated with higher numbers of pain sites at 6- (IRR 1.58, 95% CI 1.05 to 2.37), 9- (IRR 1.55, 95% CI 1.02 to 2.34), and 12-months follow-ups (IRR 1.66, 95% CI 1.10 to 2.53). Sex, BMI and interactions of age by time, mobility by time, and mental health by time interaction were associated with the most intense pain. Being male (OR 0.87; 0.82 to 0.93) and having a greater BMI (OR 1.07; 1.00 to 1.14) were associated with lower and higher pain intensity, respectively. Being older (OR 1.09; 1.01 to 1.18) and having better mobility (OR 1.06; 1.01 to 1.11) were associated with higher pain intensity at 12 months. CONCLUSION: Older adults were found to have high MSK pain prevalence, however, there was not a significant increase over time. Our results demonstrated that mobility, age, BMI, sex, and mental health are important factors associated with MSK pain in older adults.

Efficacy and safety of endoscopic "calabash" ligation and resection for small gastric stromal tumors originating from the muscularis propria.

We compared endoscopic "calabash" ligation and resection (ECLR) and endoscopic submucosal excision (ESE) in treating endophytic gastric stromal tumors (GSTs) ≤15 mm in diameter originating from the muscularis propria. We performed a retrospective study and included patients who visited our hospital for removal of small endophytic GSTs (diameter ≤ 15 mm) confirmed by postoperative pathological reports between February 2019 and December 2020. Patients were assigned to the study (received ECLR) or control (accepted ESE) groups, and their medical records were reviewed. Age, sex, GST size, resection outcomes, procedure measurements, lengths of hospital stays, medical expenses, intraoperative and postoperative complications, and follow-up outcomes were documented and compared between the two groups. Propensity score matching was used to avoid retrospective biases. A total of 277 patients were included in the analysis, with 135 in the study group and 142 in the control group. After propensity score matching, 119 cases in each group were finally included in the study. Compared to the control group, the study group had significantly shorter procedure durations and lengths of hospital stays, as well as reduced medical expenses. Compared to the control group, the study group also had significantly lower incidence rates of intraoperative stomach perforation, postoperative intraperitoneal infection, and postoperative electrocoagulation syndrome, as well as a lower intensity of postoperative pain. There were no significant differences in the other measurements between the two groups. ECLR is an effective and safe procedure for treating patients with endophytic GSTs ≤15 mm in diameter originating from the muscularis propria.

Single low-dose ketamine infusion for women with prenatal depressive symptoms undergoing cesarean delivery: A pilot randomized trial.

Ketamine is approved for antidepressant therapy, but evidence regarding its use in women with perinatal depression is lacking. Herein, we investigated the effects of low-dose ketamine in women with prenatal depressive symptoms and tested the feasibility of a future large randomized trial. This was a randomized, double-blind, placebo-controlled pilot trial. Sixty-six women with prenatal depressive symptoms who were scheduled for elective cesarean delivery were randomized to receive either low-dose ketamine (0.5 mg/kg) or placebo (normal saline). The study drugs were intravenously infused over a 40-minute period after clamping the umbilical cord. The primary outcome was depression score assessed with the Edinburgh Postnatal Depression Scale at 48 h postpartum. Among other and safety outcomes, occurrence of nausea or vomiting was observed, pain intensity was assessed with the numeric rating scale. The feasibility of implementing the protocol was also evaluated. A total of 64 parturients were included in the intention-to-treat analysis. The depression score at 48 h did not differ between groups: median 9 (interquartile range 6 to 13) with ketamine vs. 8 (6 to 10) with placebo; median difference 1, 95% CI -1 to 3; P = 0.608. The pain intensity at 4 h postpartum was less severe in the ketamine group (median difference -1, 95% CI -1 to 0, P = 0.002). Among safety outcomes, intraoperative nausea or vomiting was less common in patients given ketamine (0.0% [0/33] with ketamine vs. 21.2% [7/33] with placebo, P = 0.011). Recruitment was satisfactory and the protocol was acceptable to participants and clinicians. A single low-dose ketamine infusion did not decrease the depression score at 2 days, but reduced intraoperative nausea and vomiting and lowered pain intensity at 4 h after cesarean delivery among women with prenatal depressive symptoms. The study protocol is feasible for a large randomized trial. The study was registered with ClinicalTrials.gov (identifier: NCT03336541; 08/11/2017).

Association between pain intensity in the neck and components of a workstation: A cross-sectional study on Japanese office workers

This study aimed to investigate the association between inappropriate workstation components and neck pain intensity. This cross-sectional study was conducted on 309 Japanese office workers. Workstation questionnaires were developed based on previous studies and consisted of 11 items that assessed the armrest, monitor screen, desk, and keyboard. For each of the 11 items, we defined whether the item was “inadequate” based on previous studies. Neck pain experienced was measured using a numerical rating scale (NRS) of 0–10, and the NRS scores were categorized into three (0: “no pain,” 1–3: “low pain intensity,” and 4–10: “high pain intensity”). Crude and adjusted ordered logistic regressions were used to determine the association between the inadequate workstation and neck pain intensity. In the first analysis model, each item of the workstation questionnaire was used as an explanatory variable. Then, in the second analysis model, the number of inadequate workstation components was used as the explanatory variable. Ordered logistic regression analyses showed that the distance of the eye to the monitor was significantly associated with neck pain intensity (crude, OR: 2.21; 95% CI: 1.41–3.19; adjusted, OR: 1.79; 95%CI: 1.08–2.50). The number of inadequate workstation components had a significant positive association with neck pain intensity (crude, OR: 1.19, 95%CI: 1.04–1.34; adjusted, OR: 1.15, 95% CI: 1.00–1.32). The results of this study suggest that the distance between the eye and the monitor might be the most important workstation factor contributing to neck pain, and workstation components should be assessed collectively.

Patient-controlled sublingual sufentanil tablet system versus intravenous opioid analgesia for postoperative pain management after lumbar spinal fusion surgery

PurposeThis retrospective cohort study investigated the efficacy of a sublingual sufentanil tablet system (SSTS) in comparison to intravenous patient-controlled analgesia (IV-PCA) with piritramide for the management of postoperative pain following lumbar spinal fusion surgery.MethodsThis was a retrospective analysis of patients undergoing single- or two-level lumbar spinal fusion surgery and receiving the SSTS or IV-PCA for postoperative pain relief as part of multimodal pain management that included IV paracetamol and oral metamizole. The following variables were collected: postoperative pain intensity and frequency scores using the numerical rating scale (NRS), hospital anxiety and depression scale (HADS), occurrence of nausea, postoperative mobilization, and patient satisfaction (MacNab criteria).ResultsSixty-four patients were included. Those receiving the SSTS (n = 30) had significantly lower pain intensities on the operative day (NRS: 4.0, CI: 3.6–4.3 vs. 4.5, CI: 4.2–4.9; p < 0.05) and one day postoperatively (NRS: 3.4, CI: 3.1–3.8 vs. 3.9 CI: 3.6–4.3; p < 0.05) compared to patients receiving IV-PCA (n = 34). No differences were observed on postoperative days 2 to 5. SSTS patients experienced more nausea than IV-PCA patients (p = 0.027). Moreover, SSTS patients had a higher percentage of early mobilization following surgery than IV-PCA patients (p = 0.040). Regarding patient satisfaction, no significant differences were seen between the groups.ConclusionThe SSTS is a potentially advantageous alternative to opioid IV-PCA for use within a multimodal approach to managing postoperative pain after lumbar fusion surgery. Furthermore, the potentially higher emetic effect of SSTS should be considered, and the patient should be able to perform the application.

Are Prayer-Based Interventions Effective Pain Management Options? A Systematic Review and Meta-analysis of Randomized Controlled Trials.

This review examined the effects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large effects emerged for 67% to 69% of between-group comparisons; participants in the prayer condition reported lower pain intensity (0.59 < d < 26.17; 4 studies) and higher pain tolerance (0.70 < d < 1.05; 1 study). Pre- to post-intervention comparisons yielded medium to large effects (0.76 < d < 1.67; 2 studies); pain intensity decreased. Although firm conclusions cannot be made because meta-analysis was based on only two studies, the analysis suggested prayer might reduce pain intensity (SMD = - 2.63, 95% CI [- 3.11, - 2.14], I = 0%). (PROSPERO: CRD42020221733).

Understanding the impact of the COVID-19-related lockdown in university workers. Identifying groups through cluster analysis

ObjectiveTo analyse the COVID-19-related lockdown impact on University workers, to identify groups based on this information, and to study the factors associated with each group. Study designCross-sectional study. MethodsA survey was conducted 3.5 weeks after COVID-19-related lockdown in University workers in Spain. Sociodemographic variables, housing, work, health conditions, levels of anxiety, stress and depression (DASS-21), and social support (MSPSS) were collected. A cluster analysis was performed to identify groups depending on the impact of the lockdown. Differences between groups were tested using Chi-square and Mann-Whitney-U tests, and associated factors with binary logistic regression. ResultsWe identified two groups of workers. “G1: Consequences in the daily life routine” was mainly composed of men, Research and Teaching Personnel (RTP) with more stable professional categories, higher income level, and bigger houses than people in G2. Participants in “G2: Concerns for the current and future well-being” presented worse intensity of pain than before the lockdown, more anxiety, depression, stress and less social support than people in G1. ASP (Administration and Services Personnel) had more risk of belonging to G2 than RTP (OR = 5.863). A higher number of people living at home decreased the risk of being in G2 (OR = 0.439). People with lower pain intensity had less risk of being in G2 (OR = 0.014), and this risk decreased as friends support increased (OR = 0.833). ConclusionsIn G1, the consequences were immediately reflected in the stress resulting from changes in their daily work routine. In G2, the concerns were related to their professional future, with worse mental health, greater intensity of pain and less social support.

Impact of Digital Device Use on Neck and Low Back Pain Intensity among Nursing Students at a Saudi Government University: A Cross-Sectional Study.

As digital technology and online activities have become more widely accessible over the past few years, information and communication technology have grown in importance in all students' lives. Most of them routinely use digital devices for a range of activities, primarily for online learning, activities, assignments, conversing, and Internet browsing. This study elucidated the relationship between neck and low back pain intensity and the use of digital devices among Saudi nursing students. A cross-sectional descriptive exploratory research design was applied using a convenience sample of 120 nursing students enrolled in an undergraduate nursing program at a Saudi government university located in Riyadh, the capital city of Saudi Arabia. A valid and reliable self-administered survey was employed. Data about sociodemographic characteristics, the Neck Disability Index and the Roland-Morris Disability Questionnaire were collected. The participants reported 9.1 ± 4.6 study hours on average per week. A total of 82.5% of them do not receive enough exercise, and 87.5% indicated daily use of digital devices. Around half (54.2%) of participants reported having neck pain of a mild intensity. About 60% of the participants regularly shift positions to rest their backs, 39.2% are only able to stand for limited periods due to back issues, and 39.2% expressed concern for others about what might happen to their health. Although there was an association between neck pain intensity and the age or gender of all research participants, there was a significant association between neck pain severity and marital status (χ2 = 15.226, p = 0.019). Our findings suggest that nursing students should maintain neutral neck and back postures on a regular basis to reduce pain, which could be attributed to extensive reading on digital devices.

The effect of transcutaneous electrical nerve stimulation (TENS) on decreasing primary dysmenorrhea pain in adolescents

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;Dysmenorrhea is medical condition indicated by an increase of the prostaglandin (PG) F2-alpha hormone and cyclooxygenase (COX-2) causing hypertonic as well as vasoconstriction activity to the myometrium. It leads to ischemia and stimulating pain in the uterine organs. The condition influence quality of life and productivity of majority female patients. Dysmenorrhea incidence in Indonesia is reported by 64.25% and a total of 52% of students in Yogyakarta experienced drop activity during menstruation. &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Objectives: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;This study aimed to evaluate the effect of&lt;/em&gt;&lt;em&gt; TENS&lt;/em&gt;&lt;em&gt; in reducing primary dysmenorrhea pain among female adolescents in General Ahmad Yani University Yogyakarta&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Methods: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;A quasi experiment study with pretest-posttest control group design was conducted. A total of 24 participants for intervention and control group were recruited. In order to recruit study participants, this research implemented a quota sampling approach. Primary dysmenorrhea pain measured using Numerical Rating Scale (NRS) and bivariate analysis between both groups carried out using T-test.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Results: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;A&lt;/em&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;significant difference (p&amp;lt;0.05) reported from both groups before and after the intervention. Prior to the treatment, the average pain score for intervention group was 6 (1.70) and ranging from 4-10. After the treatment being delivered, the intervention group experienced lower pain intensity by average 3.42 (1.6) between 1-6 score range. Control group in this study reported average pain score before the intervention by 4 (1.16) with and ranging from 3-6. The treatment decreased control group participants pain level to average 1.50 (0.52) between the range of 1-2. TENS is effective for severe pain management. Effleurage massage suitable for moderate level pain management. TENS intervention effective to lower pain by 3.50%.&lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Conclusions: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;TENS and massage intervention potential to decrease pain intensity of primary dysmenorrhea. This study reported lower pain level associated with TENS by 3.50%. TENS had significant effect for reducing dysmenorrhea pain by 3.50%.&lt;/em&gt;

Kinesiophobia and associated factors in patients with traumatic lower extremity amputation.

The study aimed to demonstrate the level of kinesiophobia in patients with traumatic lower limb amputation (LLA) and to investigate the correlation between kinesiophobia and associated factors. This cross-sectional study included 52 male patients (mean age: 37.8±8.7 years; range, 18 to 65 years) with traumatic LLA between March 2021 and July 2021. Kinesiophobia level was measured with the Tampa Scale for Kinesiophobia. Pain intensity and prosthesis satisfaction were evaluated with the Visual Analog Scale. The Falls Efficacy Scale-International was used for the assessment of fear of falling. The Nottingham Health Profile was used to evaluate the quality of life. The percentage of the patients with a high level of kinesiophobia was 40.4%. Kinesiophobia was significantly correlated with residual limp pain intensity (r=0.317, p=0.022), the number of falls (r=0.284, p=0.041), fear of falling (r=0.495, p=0.001), and quality of life (r=0.512, p=0.001). No significant correlations between kinesiophobia and intact limb pain intensity, low back pain intensity, or prosthesis satisfaction were detected. Regression analysis showed that the physical activity subscale score of the Nottingham Health Profile was a statistically significant predictor of high kinesiophobia scores. The findings suggest that limitations in physical activity were independently associated with kinesiophobia in patients with traumatic LLA. Fear and avoidance behaviors, which may limit physical activity, should be considered in the evaluation of individuals with LLA.

Early surgical intervention alleviates sensory symptoms following acute traumatic central cord syndrome.

To investigate the impact of early versus delayed surgery on sensory abnormalities in acute traumatic central cord syndrome (ATCCS). Pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM) and pain assessments were performed in 72 ATCCS patients (early vs. delayed surgical treatment: 32 vs. 40) and 72 healthy subjects in this ambispective cohort study. These examinations, along with mechanical detection threshold (MDT) and disabilities of arm, shoulder and hand (DASH), were assessed at 2years postoperatively. Preoperatively, more delayedsurgical patients had neuropathic pain below level compared with earlysurgical patients (P < 0.05). Both early and delayedsurgical patients showed reduced PPT in common painful areas and increased TS, while reduced CPM only existed in the latter (P < 0.05). Reduced PPT in all tested areas, along with abnormalities in TS and CPM, was observed in patients with durations over 3months. Both incidences and intensities of pain and pain sensitivities in common painful areas were reduced in both treatment groups postoperatively, but only early surgical treatment improved the CPM and TS. Follow-up analysis demonstrated a higher MDT and lower PPT in hand, greater TS, greater DASH, lower pain intensities and higher incidence of dissatisfaction involving sensory symptoms in delayedsurgical patients than in earlysurgical patients (P < 0.05). Central hypersensitivity may be involved in the persistence of sensory symptoms in ATCCS, and this augmented central processing may commence in the early stage. Early surgical treatment may reverse dysfunction of endogenous pain modulation, thus reducing the risk of central sensitization and alleviating sensory symptoms.

15-item Roland-Morris Disability Questionnaire (RMDQ-15): structural and criterion validity on patients with chronic low back pain

BackgroundThe Roland-Morris Disability Questionnaire (RMDQ) is one of the most used instruments to measure self-reported disability in patients with low back pain, however, the uncertainty on which version to use may lead to inadequate disability measurement and consequently, improper management of patients with chronic low back pain.ObjectiveTo propose a short version of the RMDQ, compare it with the other short versions presented by the specialized literature, and identify the best internal structure of the RMDQ for the Brazilian population.MethodsThis is a cross-sectional study in which we used confirmatory factor analysis to identify the best structure of the RMDQ. We assessed 545 participants, most of which were women, aged ≥ 30 years old, single, with mean low back pain intensity ~ 5 points, and mean pain chronicity ~ 72 months. We used lavaan and semPlot packages, with implementation of a tetrachoric matrix and the robust diagonally weighted least squares extraction method. We also used fit indices chi-square/degree of freedom, comparative fit index, Tucker-Lewis index, root mean square error of approximation, and standardized root mean squared residual. For the comparison between models, we considered the structure with the lowest values of the Akaike information criterion and Bayesian information criterion. In addition, we assessed criterion validity via Spearman’s correlation coefficient to correlate the long and short versions. In this study, the 15-item structure was created through the use of modification indices to identify redundant items (9 items were excluded).ResultsRMDQ structure with one domain and 15 items and the structure with two domains and 16 items showed all fit indices with adequate values, but the one-dimensional version showed the lowest Akaike information criterion and Bayesian information criterion values. Regarding criterion validity, correlation between the RMDQ with 24 items and 15 items is adequate (rho = 0.954, p < 0.001).ConclusionThe RMDQ-15 is a short version of the RMDQ instrument with the most adequate internal structure and satisfactorily correlated with the long version of the instrument.

Serum Sickness-Like Reaction Associated with Epstein – Barr Virus: Clinical Case

Background. Annular dermatoses are a group of diseases with major clinical manifestation of rashes of relevant form. This manifestation pattern causes difficulties in diagnosis. The case of rarely diagnosed annular dermatosis is presented: serum siknesslike reaction (SSLR) triggered by the Epstein – Barr virus (EBV).Clinical case description. Patient D., 8 years old girl, noted abdominal pain 3 weeks before hospitalization, and later numerous polymorphic rashes (erythematous macules, urticarial elements), swelling and pain in joints. Self-treatment with non-steroidal anti-inflammatory and systemic antihistamines did not lead to any improvement. The patient was hospitalized in the pediatric department at the place of residence, where the diagnosis “Henoch-Schonlein purpura, mixed type” was established according to the results of physical, laboratory (double increase of ALT and AST, ESR up to 166 mm/h, IgM to EBV), and ultrasound (mesenteric lymph nodes hyperplasia) studies. Systemic glucocorticosteroids have led to improvement, however, few days after the end of the treatment there was relapse of rash and arthralgia. Thus, the girl was administrated to clinical diagnostic center. Patient’s general condition was satisfactory at the time of examination. There were numerous erythematous annular urticarial and macular elements (3–12 cm) on the skin of face, body and limbs. Some foci, as well as some resolved rashes had blue spots with indistinct boundaries that disappeared after compression. Mucous membranes, nails and hair were intact. Subjective symptoms — slight burning around rashes, at palpation — low-intensity pain in the left radiocarpal joint. Blood tests: C-reactive protein concentration increased up to 12 mg/L, ESR up to 26 mm/h, IgG to EBV up to 47.7.Conclusion. During differential diagnosis we should consider the possibility of SSLR development in all pediatric patients with annular rashes associated with arthralgia and/or arthritis, fever, history of drug use (most often beta-lactam antibiotics), recent vaccination or manifestations of viral infection, especially in case of cyanotic spots after rashes resolution and non-specific laboratory parameters.

Effect of Acupressure on Low Back Pain Intensity and Depression in Patients with Chronic Nonspecific Low Back Pain

Background: Low back pain (LBP) is the leading cause of disability in the world. This study aimed to evaluate the effect of acupressure on LBP intensity and depression among chronic nonspecific LBP patients. Methods: This sham-controlled randomized clinical trial was performed on 84 patients with chronic nonspecific LBP. The data were collected using a demographic information questionnaire, the Visual Analogue Scale (VAS), and the Beck Depression Inventory-II (BDI-II). The participants were randomly assigned to acupressure (n = 42) and sham (n = 42) groups. The acupressure group was trained on how to apply pressure on Yin tang, Feng Chi, and Shu Fu acupoints; nevertheless, the sham group was trained on how to apply pressure on Chen Jiang, Huang Shu, and Ji ache acupoints. The participants in both groups applied acupressure once a day for 4 weeks. Both groups completed the VAS and the BDI-II again one day after the intervention. Results: No significant differences in LBP intensity (P = 0.45) and depression (P = 0.26) were observed between the two groups before the intervention. By controlling the baseline scores of LBP and depression, analysis of covariance revealed that the LBP and depression of the acupressure group significantly improved after the intervention, compared to the sham group (P &lt; 0.05). Conclusions: Applying pressure on Shu Fu, Yin Tang, and Feng Chi points is effective in reducing LBP and depression among chronic nonspecific LBP patients. The findings of this study can be used in designing and evaluating more robust protocols.

Pain as a risk factor for incident sarcopenia in community-dwelling older adults: A 1-year prospective cohort study.

Pain-related muscle disuse and inflammatory reactions may increase the risk of sarcopenia among older adults with pain. Although several studies have examined the association between pain and sarcopenia, the findings are mixed. In the present study, we examined the association of pain as well as pain intensity and location with incident sarcopenia among community-dwelling older adults and explored whether this association differed between men and women. Pain characteristics, including the presence of pain, intensity (mild, moderate, and severe), and location (multisite, low back, joint, and chest), were self-reported at baseline. Sarcopenia was identified according to the consensus of the Asin Working Group for Sarcopenia 2019 at baseline and 1 year later. Multivariable Poisson regression was used to determine the association of pain status, intensity, and location with incident sarcopenia, respectively. Eight hundred seventy-three participants (67.1± 4.9 years, 524 female) who were free of sarcopenia at baseline were included, of which 64 (7.3%) developed sarcopenia in the follow-up. The presence of pain was significantly associated with an increased risk of incident sarcopenia in older adults (adjusted RR=1.83, 95% CI=1.16-2.89), with a significant risk accumulation in incident sarcopenia upon higher pain intensity. Older adults with multisite pain, low back pain, or joint pain were more likely to develop sarcopenia. Although older men reported a lower prevalence and intensity of pain, their risk of sarcopenia during follow-up was generally more pronounced than older women. Older adults with pain had a significantly higher risk of incident sarcopenia, with a significant risk accumulation in sarcopenia development upon higher pain intensity and specific pain location. Additional attention is needed to identify older adults with pain and to implement timely pain interventions to prevent sarcopenia. High-quality randomized controlled trials are warranted to verify the clinical significance of the present study.

Clusters of facilitatory and inhibitory conditioned pain modulation responses in a large sample of children, adolescents, and young adults with chronic pain.

When investigating the role of facilitatory and inhibitory pain mechanisms such as conditioned pain modulation (CPM) and temporal summation of pain (TSP), it is important to take both into consideration in a single experimental model to provide the most information on subgroups of patients. Therefore, the objective of this study was to identify subgroups in a large population of pediatric patients with chronic pain based on their facilitatory and inhibitory pain mechanisms and compare them with control subjects. Five hundred twenty-one female subjects and 147 male subjects between 8 and 21 years old underwent a CPM assessment using a 2-minute tonic noxious heat stimulation as the test stimulus and a 2-minute cold-pressor task (CPT) (12°C) as the conditioning stimulus. The best partition of clusters of patients was 3 clusters accounting for 27.15% of the total variation in the data. Cluster 1 (n = 271) was best characterized by high pain intensity during the CPT, lack of TSP during the test stimuli, and efficient inhibitory CPM. Cluster 2 (n = 186) was best characterized by low pain intensity during the CPT, lack of TSP during the test stimuli, and efficient inhibitory CPM. Cluster 3 (n = 151) was best characterized by high pain intensity during the CPT, presence of TSP during the test stimuli, and inefficient inhibitory CPM. A single thermal CPM experimental design can identify combinations of facilitatory and inhibitory pain modulation responses. Findings from the current study add to the literature by describing different clinical phenotypes of central pain mechanisms of youth with chronic pain.

Health-related quality of life among spondyloarthritis and chronic low back pain patients: results from a nationwide population-based survey.

Both spondyloarthritis and chronic low back pain (CLBP) significantly impact health-related quality of life (HRQoL). It is important to clarify whether these disorders have different impacts on the several domains of HRQoL as different mechanisms may necessitate different treatment interventions. Moreover, the factors associated with HRQoL can inform more targeted group interventions to promote HRQoL. We used data from EpiReumaPt, a population-based survey conducted from September 2011 to December 2013. HRQoL was assessed with EuroQoL-5-Dimensions (EQ-5D). Spondyloarthritis was diagnosed by expert opinion (rheumatologist) and predefined criteria. CLBP was diagnosed if low back pain was present on the day of the interview and persisted for > 90days. Univariable and multivariable linear regression analyses compared HRQoL among subjects with spondyloarthritis, CLBP, and no rheumatic diseases. Multivariable linear regression analyses evaluated HRQoL factors in spondyloarthritis and CLBP subjects. We included 92 spondyloarthritis patients, 1376 CLBP patients, and 679 subjects without rheumatic diseases. HRQoL was similarly affected in spondyloarthritis and CLBP (ß = - 0.03, 95% CI [- 0.08; 0.03]) in all EQ5D dimensions. A much lower HRQoL was found in spondyloarthritis and CLBP patients compared with subjects without rheumatic diseases (ß = - 0.14, 95% CI [- 0.19; - 0.10]; ß = - 0.12, 95% CI [- 0.14; - 0.09], respectively). In spondyloarthritis subjects, multimorbidity and active disease were associated with worse HRQoL (ß = - 0.18; 95% CI [- 0.24; 0.03]; ß = - 0.13; 95% CI [- 0.29; - 0.05], respectively), and regular physical exercise was associated with better HRQoL (ß = 0.18; 95% CI [0.10; 0.30]). In CLBP subjects, multimorbidity (β = - 0.11; 95% CI [- 0.14; - 0.08]), obesity (β = - 0.04; 95% CI [- 0.08; - 0.01]), and low back pain intensity (β = - 0.02; 95% CI [- 0.03; - 0.02]) were associated with worse HRQoL, and regular physical exercise (β = 0.08; 95% CI [0.05; 0.11]) was significantly associated with better HRQoL. Spondyloarthritis and CLBP subjects reported similar levels of impairment in the mental, physical, and social domains of HRQoL. Future health plans should address modifiable factors associated with HRQoL in these conditions to achieve better outcomes.