Self-reported Bodily Pain Research Articles

Abstract B043: Is pain preventing African Americans from reducing their cancer risk?

Abstract Introduction: The purpose of this study is to describe the prevalence of bodily pain and its association with cancer prevention and risk reducing lifestyle factors among African Americans. Background: Bodily pain can impact an individual’s psychological, physical and socioeconomic well-being and studies have shown that African Americans have a higher prevalence of reporting bodily pain. Additionally, African Americans report a higher prevalence of modifiable cancer risk factors, such as physical inactivity and obesity. We sought to examine the association between physical activity, sedentary time, obesity, sleep, and psychosocial factors (i.e., depression) and self-reported bodily pain among a convenience sample of African Americans church goers. Methods: Participants were recruited from a large mega church in Houston, Texas and surveys were completed on-site using a computerized questionnaire. Multivariable logistic regression models were used to examine associations between bodily pain and cancer risk factors. Analyses were adjusted for age, gender, income, educational level, employment status, chronic conditions and depression. Results: Of a total of 1408 participants, the average age was 51 and 1065 (76%) of the sample were females. 218 (15%) reported moderate to extreme pain; more than half (N=805, 57%) of the sample reported having chronic conditions; and 268 (19%) reported having depression. Slightly more than half, (N= 745,53%) of the sample was obese, 335 (24%) reported low physical activity, 403 (29%) reported sleeping 5 hours or less and 305 (22%) reported very bad/fairly bad sleep quality. The average hours spent per day in sitting and sedentary time were 6 and 9 respectively. Chi-square tests revealed significant associations between moderate to extreme bodily pain and education (p < 0.001), income (p < 0.001), employment status (p < 0.001), chronic conditions (p < 0.001), depression (p < 0.001), BMI (p < 0.001), physical activity (p < 0.001), sleep duration (p < 0.001), sleep quality (p < 0.001) and sedentary time (p < 0.001). Increased hours spent in sedentary time was associated with higher odds of reporting pain (OR=1.08 (1.03- 1.12). Medium and high physical activity (OR=0.63 (0.41- 0.96)) and (OR=0.51 (0.34- 0.77)), reporting 6 hours or more of sleep (OR=0.69 (0.49- 0.98)) and reporting very good/fairly good sleep quality (OR=0.57 (0.39- 0.84)) were associated with lower odds of reporting bodily pain. Obesity and increased hours per day in sitting time (e.g., watching tv) were not significantly associated with bodily pain. Conclusions: African Americans are at risk for both bodily pain and modifiable cancer risk factors and our findings suggest an association between bodily pain and less engagement in healthy lifestyle factors. Findings can inform interventions aimed at reducing cancer risk among African Americans by addressing undetected barriers like bodily pain. Citation Format: Tiffany Suragh, Lorna H. McNeill, Nga Nguyen. Is pain preventing African Americans from reducing their cancer risk? [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B043.

Development and internal validation of the Edmonton Obesity Staging System-2 Risk screening Tool (EOSS-2 Risk Tool) for weight-related health complications: a case-control study in a representative sample of Australian adults with overweight and obesity

ObjectiveExcess weight and related health complications remain under diagnosed and poorly treated in general practice. We aimed to develop and validate a brief screening tool for determining the presence of...

Prevalence of musculoskeletal disorders among Canadian firefighters: A systematic review and meta-analysis

Introduction: Firefighters are set to respond to a number of dynamic demands within their roles that extend well beyond fire suppression. These tasks (i.e., heavy lifting, awkward postures) and their unpredictable nature are likely contributing factors to musculoskeletal disorders (MSDs). Several individual studies have assessed the prevalence of MSDs among Canadian firefighters. Therefore, a systematic review and meta-analysis was conducted to critically appraise the quality of the body of available literature and to provide pooled point- and period-prevalence estimates of anatomical regions of MSDs among Canadian firefighters. Methods: The MEDLINE, Embase, PubMed and Web of Science databases were searched from inception to November 2018. Cross-sectional cohort studies with musculoskeletal prevalence estimates (point- and period-) of career/professional firefighters in Canada were identified and critically appraised. MSDs were defined as sprains/strains, fractures/dislocations and self-reported bodily pain (chronic or acute). Period- and point-prevalence estimates were calculated, and study-specific estimates were pooled using a random-effects model. Results: Five eligible cohort studies (3 prospective, 2 retrospective) were included, with a total of 4,143 firefighters. The participants had a mean age range of 34 (SD = 8.5) to 42.6 (SD = 9.7) years. The reported types of MSDs included sprain or strain, fractures, head, neck, shoulder, elbow, arm, hand, back, upper thigh, knee, and foot pain. The point-prevalence estimate of shoulder pain was 23.00% (3 studies, 312 of 1,491 firefighters, 95% CI, 15.00–33.00), back pain was 27.0% (3 studies, 367 of 1,491 firefighters, 95% CI, 18.00–38.00), and knee pain was 27.00% (2 studies, 180 of 684 firefighters, 95% CI, 11.00–48.00). The one-year period-prevalence estimate of all sprain/strain injuries (all body parts) was 10.0% (2 studies, 278 of 2,652 firefighters, 95% CI, 7.00–14.00). Discussion: High point-prevalence estimates (1 in 4 firefighters) of shoulder-, back-, and knee-related MSDs were identified among Canadian firefighters. This emphasizes the need for early assessment, intervention, and injury prevention strategies that reflect how units work together to maximize ergonomic efficiency and injury prevention.

Sociodemographic patterns of pain in an urban community sample: an examination of intersectional effects of sex, race, age, and poverty status.

Pain disparities based on race, sex, age, and socioeconomic status have been well documented. This study aimed to examine interactions among these sociodemographic factors on self-reported bodily pain in an urban community sample to assess whether membership in multiple at-risk groups confers greater risk for pain independent of depressive symptomatology. Participants (N = 1173) were enrolled in the epidemiological Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, and reported experiences of pain in various body sites. Logistic regression was used to examine independent and interactive relations of sociodemographic factors on the likelihood of reporting pain in one or more sites. A significant three-way interaction was found for race, sex, and poverty status (odds ratio [OR] = 6.04, 95% confidence interval [CI] [1.26-28.97], P = 0.025). Specifically, among Whites living in poverty, women were more likely to report pain than men (P = 0.043), suggesting a double disadvantage of being both female and living in poverty. Among those above the poverty line, African American (AA) men were less likely to report pain than White men (P = 0.024) and AA women (P = 0.019), potentially due to greater stoicism or coping skills and sources of resilience. Consistent with prior research, significant main effects revealed that older age (OR = 2.16, 95% CI [1.28-3.64], P = 0.004) and higher depressive symptoms (OR = 1.03, 95% CI [1.02-1.04], P < 0.001) were associated independently with increased likelihood of reporting pain. This study demonstrates that in an urban population, intersecting sociodemographic factors create unique social identities that impact pain, and emphasizes the need for identification of relevant mediational pathways.

The pain of weight-related stigma among women with overweight or obesity.

Pain is prevalent among individuals with overweight or obesity but few studies have examined the mechanism linking pain with excess body weight. Because there is evidence that social and physical pain may be processed through similar physiological mechanisms, weight-stigma may potentiate the experience of physical pain through shared neuroanatomical pathways. This study evaluated the relationship between perceived weight stigma and self-reported bodily pain in a sample of overweight and obese adult women. Sixty-one women with a body mass index (BMI) between 25-35 completed self-report questionnaires assessing perceived stigma, internalized weight stigma, and self-reported pain. Height and weight were measured and participants completed a demographic and health history questionnaire. Hierarchical regression analyses were utilized to predict self-reported pain from perceived stigma, adjusting for demographic variables associated with self-reported pain as well as pain-related conditions. Perceived stigma was associated with pain F(6, 54)=6.10, p<.001) as was internalized stigma. Perceived stigma mediated the relationship between BMI and bodily pain among individuals with a BMI in the overweight range but not among individuals with a BMI in the obese range. Weight-related stigma among women with overweight or obesity appears to be associated with greater experience of physical pain. These results underscore the need to evaluate multiple mechanisms that might explain the relationship between bodily pain and body weight and to determine how the relationship may vary across different subgroups of individuals.

Headache attributed to TMD Is Associated With the Presence of Comorbid Bodily Pain: A Case-Control Study.

The objective of this case-control study is to investigate the phenotypic characteristics of chronic TMD with and without TMDH. We hypothesize that chronic TMD with TMDH is associated with increased number of bodily pain conditions, more painful sites in the head and neck region, and greater TMD pain intensity. This is a retrospective cross-sectional review of the medical records of consecutive patients who sought treatment at the University of North Carolina Orofacial Pain Clinic between 2013 and 2014. The inclusion criterion was a diagnosis of myalgia or arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders. In addition, cases had a diagnosis of TMDH according to the ICHD-3 criteria. Data on the presence and the number of self-reported bodily pain conditions (such as fibromyalgia and low back pain), pain intensity, number of painful sites in the head and neck upon palpation, and TMD pain onset were analyzed. A total of 295 records were reviewed. Thirty-four (29.3%) patients fulfilled inclusion criteria for cases (TMD+TMDH) and 82 (70.7%) for controls (TMD-TMDH). Cases reported greater number of bodily pain conditions than controls, with a mean of 1.97±1.50 and 1.26±1.28 of bodily pain conditions, respectively (P=.012, OR=1.43 [95% CI 1.07-1.92]). In fact, 55.9% of cases reported at least 2 comorbid pain conditions compared to 37.8% controls (P=.044). Compared to controls (8.65±5.32), cases (13.05±4.46) exhibited greater number of painful sites upon palpation in the head and neck region (P<.0001, OR=1.18 [95% CI 1.09-1.30]), and greater TMD pain intensity, with a mean of 6.00±2.17 for cases and 5.09±2.14 for controls (P=.041, OR=1.22 [95% CI 1.01-1.47]). In a population of patients with chronic TMD seeking pain management, TMDH was significantly associated with an increased number of self-reported bodily pain conditions, a greater number of painful sites in the head and neck regions, and higher TMD pain intensity.

Loss of Temporal Inhibition of Nociceptive Information Is Associated With Aging and Bodily Pain.

Older and middle-aged adults showed reduced offset analgesia compared with younger adults. The significant association between reduced offset analgesia and pain in daily life supports the notion that pain modulatory deficits are associated with not just a chronic pain condition but with the experience of pain in general.

Reduction of Bodily Pain in Response to an Online Positive Activities Intervention

Inducing temporary positive states reduces pain and increases pain tolerance in laboratory studies. We tested whether completing positive activities in one's daily life produces long-term reductions in self-reported bodily pain in a randomized controlled trial of an online positive activities intervention. Participants recruited via the Web were randomly assigned to complete 0, 2, 4, or 6 positive activities administered online over a 6-week period. Follow-up assessments were collected at the end of 6 weeks and at 1, 3, and 6 months postintervention. We used linear mixed effects models to examine whether the intervention reduced pain over time among those who had a score <67 on the bodily pain subscale of the Short Form-36 at baseline (N = 417; pain scores range from 0 to 100; higher scores indicate less pain). Mean pain scores improved from baseline to 6 months in the 2-activity (55.7 to 67.4), 4-activity (54.2 to 71.0), and 6-activity (50.9 to 67.9) groups. Improvements were significantly greater (P < .05) in the 4-activity and 6-activity groups than in the 0-activity control group (54.1 to 62.2) in unadjusted and adjusted models. This study suggests that positive activities administered online can reduce bodily pain in adults with at least mild to moderate baseline pain. PerspectiveThis study demonstrates that teaching people simple positive activities can decrease reported levels of bodily pain; moreover, these activities can be administered over the internet, a potential avenue for broadly disseminating health interventions at relatively low costs and with high sustainability.

Correlates of non-medical prescription drug use among a cohort of injection drug users in Baltimore City

Despite reports of increasing non-medical prescription drug use, relatively few studies have systematically evaluated the prevalence and correlates of non-medical prescription drug use, particularly in populations that might be especially vulnerable (e.g., injection drug users [IDUs]). We examined factors associated with non-medical prescription drug use among a community-based cohort of current and former IDUs in Baltimore (The ALIVE Study). We conducted a cross-sectional analysis of data from cohort participants that responded to a survey that included questions on non-medical prescription drug use between 2005–06 (n = 1320). Non-medical prescription drug use was considered to be use of any of the following: Opiates (Oxycontin, Percocet), Benzodiazepines or Clonidine, purchased on the street and taken orally within the last six months. Data on other covariates of interest (e.g., demographics, substance use, general health) was obtained through a standardized interview. The median age was 46 years; 66% were male, 85% were African-American. Twenty one percent reported any non-medical prescription drug use; 12% reported using more than one drug. Non-medical use of opiates was most common (17%). In multivariate analysis, non-medical prescription drug use was significantly associated with Caucasian race (prevalence ratio [PR]: 1.79), self-reported bodily pain (PR: 1.58), hazardous alcohol use (PR: 1.47), marijuana use (PR: 1.65), non-injection cocaine/heroin use (PR: 1.70), diverted use of buprenorphine (PR: 1.51) or methadone (PR: 2.51), and active injection drug use (PR: 3.50; p < 0.05 for all). The association between bodily pain and non-medical prescription drug use was stronger among persons that were not using substances (marijuana, injecting drugs, snorting/smoking heroin, cocaine, using crack) as compared to those using these substances. The high prevalence of non-medical prescription drug use among this population warrants further research and action. Information on the risks of nonmedical prescription drug use especially overdose, should be incorporated into interventions targeted at IDUs.

Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls

Polyunsaturated fatty acid (PUFA) levels are altered in adults with cognitive decline and also depression. Depression facilitates progression from mild cognitive impairment (MCI) to dementia. We investigated associations between omega-3 (n-3) and omega-6 (n-6) PUFAs and cognition, memory and depression in 50 adults ≥65 years with MCI and 29 controls. Memory, depressive symptoms and erythrocyte PUFAs (% total fatty acids) were assessed. Eicosapentaenoic acid (EPA) was lower in MCI vs controls (.94% vs 1.26%, p<.01); n-6 PUFAs were higher: dihomo-gamma-linolenic acid (1.51% vs 1.32%, p<.01), arachidonic acid (11.54% vs 10.70%, p<.01), n-6 docosapentaenoic acid (DPA:.46% vs.34%, p<.01), and total n-6 PUFA (24.14% vs 23.37%, p<.05). Higher n-6 DPA predicted poorer mental health. Lower n-3 DPA was associated with higher self-reported bodily pain. Adults with MCI had higher depression scores (3.05±.39 vs 1.33±.24, p<.01). Depressive symptoms associated with elevated n-6 PUFA may contribute to cognitive decline in this population.

Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy

We examined prospectively the results of withdrawal therapy in 80 patients with probable medication overuse headache. The aim was to identify baseline patient characteristics that might predict outcome after 1 year (end of study). We classified patients according to results of withdrawal therapy measured as the improvement of headache days (HD) from baseline to end of study. Thirty-six per cent (29/80) had at least 50% improvement. Sixty-four per cent (51/80) had <50% improvement, and among these, 30% (24/80) had <10% improvement. The following baseline characteristics were associated with poor outcome of withdrawal therapy: use of codeine-containing drugs, low self-reported sleep quality, and high self-reported bodily pain as measured by the quality of life tool SF-36. Before suggesting withdrawal therapy, one should probably pay more close attention to sleep problems.

Degree of body weight in obesity and Rorschach personality aspects of mental distress.

To study the relationship between degree of obesity and personality measures of mental distress. The Rorschach method (Comprehensive System) and the Beck Depression Inventory. General descriptors were also included. Participants were 120 obese patients with a mean body mass index (BMI) of 41 (+/- SD 6) kg/m2. Depression, stress or psychopathology such as distortions in perception and cognitions were not related to the degree of obesity. Body concern and body-related anxiety (An+Xy) were more common in relatively lower degrees of obesity. According to general descriptors heavier patients had lower educational and socio-economic level, and more bodily pain problems. Depression was not related to body weight, in spite of findings of more depression in obesity compared to normal weights. Other factors than severity of obesity would account for the mental distress in obese patients. The differences in body concern and anxiety in varying degrees of obesity could be related to the social and educational context, where attitudes toward obesity differ. Less Rorschach signs of body concern in the morbidly obese contrasted with more self-reported bodily pain problems.

Bodily pain, sleep problems and mental distress in schoolchildren.

It has been suggested that childhood pain could be the beginning of a career with chronic disabling pain. Bodily pain is frequent in children. We examined the association between self-reported bodily pain, mental distress and sleep problems in schoolchildren to test the following hypotheses: (i) that self-reported bodily pain is associated with mental distress and sleep problems, (ii) that the association is dependent on the localization of pain, and (iii) that the association increases with number of painful areas. Eighty-six percent of the pupils (569) in the 4th form (mean age 10.5 y), 7th form (mean age 13.5 y) and 9th form (mean age 15.5 y) from all the schools in a local community answered a questionnaire about self-esteem, body-image, physical activity and bodily pain. We found a strong association between the reporting of pain, mental distress and sleep problems. Pain in the knees was the only problem reported more frequently by boys than by girls, and knee pain did not show the same association with mental distress and sleep problems as pain from other regions. A possible cause-effect relationship between pain, mental distress and sleep problems is discussed, and the possibility that all the complaints are the simultaneous signs of a multisymptom syndrome is introduced.

Self-reported Bodily Pain in Schoolchildren

It has been suggested that musculoskeletal symptoms develop from early age and can be regarded as a lifespan phenomenon. The study of childhood pain might provide a better understanding of the origin of chronic pain in adults. In a study of 569 schoolchildren, aged 10-15 years, in a local community close to Oslo, 75% reported that they usually experience bodily pain. Girls reported more pain than boys. 25% of those reporting pain experience symptoms several days a week. Knee symptoms and back pain were most frequently reported. Thirty-seven % of the girls reported headache, only 20% of the boys. Girls also reported more neck and shoulder pain than boys. The oldest respondents reported symptoms from more body parts. Symptoms from several body parts were more frequent among girls. Thirty-eight% of the respondents reported that it sometimes is hard to concentrate because of the pain, and 26% reported that they sometimes have to use medication. The consequences of pain increased with increasing age and increasing number of body parts affected. The results are consistent with findings in the adult population.