Significant Predictors Of Pain Research Articles

Clinical manifestations of interstitial cystitis and bladder pain syndrome: Analysis of a patient registry in Japan.

To describe clinical manifestations of patients with interstitial cystitis and bladder pain syndrome (IC/BPS) using a patient registry in Japan. This retrospective cohort study utilized a patient registry supported by the Japanese Ministry of Health, Labor, and Welfare. Patients were classified as IC or BPS based on cystoscopic findings. Data on demographics, comorbidities, symptom severity, pain intensity, and bladder function were collected and we evaluated the differences in clinical characteristics between IC and BPS, and used multivariate analysis to search for additional factors that might contribute to pain. A data set comprising 529 patients was obtained from 14 university hospitals. 66.5% of the cases were classified as IC and 33.5% as BPS. IC patients were significantly aged and female-dominant. Comorbidities such as autoimmune diseases were more prevalent in IC patients. All of the symptom severity, quality of life impairment, and bladder function were significantly worse in patients with IC. Urinary frequency and maximum voided volume on the Frequency-volume chart were 18.8 times and 15.0 times, and 160.9 and 214.1 mL, respectively. Bladder capacity under anesthesia was 293.8 and 472.6 mL, respectively. Maximum voided volume and the number of Hunner lesions were significant predictors of pain in IC patients. The analysis revealed clinical manifestations of IC/BPS using the largest cohort in Japan. The results indicated higher age, higher female proportion, and higher symptomatic and functional severity in IC patients compared to BPS.

Total knee replacement in different age groups

To evaluate the efficacy and quality of life in long-term period (1 year) after total knee replacement in various age groups. We studied 134 patients after unilateral primary total knee replacement. The KOOS and SF-36 questionnaires were used to assess the therapeutic effect (functionality and symptoms) and quality of life in patients with knee osteoarthritis. At baseline, group I (young patients) had low KOOS pain scores (39.42±16.42), function scores (50.18±19.16) and QoL scores (18.2±15.9) compared to other age groups. A year after surgery, group I (<55 years) had significantly lower KOOS scores of pain, function and quality of life compared to group III (>65 years). Multiple regression analysis showed that age was a significant predictor of pain, but not a function after a year. Total knee replacement gives a noticeable improvement in pain, functionality and quality of life in all age groups. However, there are significant age-related differences in preoperative assessment of pain, quality of life and mental health, as well as in final indicators of postoperative pain and quality of life. Indeed, young patients (<50 years) report more intense pain and worse quality of life. These data may be used in clinical practice to improve decision-making and patient expectations before total knee replacement.

Neck and upper extremity musculoskeletal problems in cosmetologists caused by work-related ergonomic risk factors in Denizli, Turkey.

Work-related musculoskeletal disorders (MSDs) of the neck and upper limbs are a common health problem among cosmetologists. Hairdressing requires bending, twisting, static postures, prolonged standing, repetitive motions, and vigorous movements of the hands and fingers. In order to determine the proper ergonomic measures, identifying the factors and hairdressing jobs that increase the risk of work-related neck and upper limb disorders is needed. The objective of this study was to determine the prevalence of MSDs in the neck and upper extremities of cosmetologists and to investigate the association with ergonomic risk factors and hairdressing work. The cross-sectional study was conducted on cosmetologists in Denizli, Turkey province (n = 504). Data collected through a survey included questions on sociodemographic characteristics, work organization, equipment, and hairdressing work, items on work posture, the Extended Nordic Musculoskeletal Questionnaire, and the Demand-Control-Support Questionnaire. Work posture in hairdressing was assessed using the Rapid Upper Limb Assessment (RULA). The prevalence of MSDs of the neck and upper limbs in the previous twelve months ranged from 7.7-55.8%. There was high, or very high, risk in 56.1% of work postures, and the median RULA score was 5.0 (4.0-6.0). The significant predictors of pain were work experience, gender, marital status, risk perception, awkward posture, psychological demand, and hair coloring. It is necessary to take control measures in hairdressing salons promptly to adopt more suitable working posture and to design workplaces ergonomically.

Predictors of chronic pain and disability in patients treated conservatively after distal radius fracture: a prospective cohort study.

To determine predictors of chronic pain and disability among patients with distal radius fractures (DRF) treated conservatively with closed reduction and cast immobilization. This was a prospective cohort study. Information on patient characteristics, post-reduction radiographic parameters, finger and wrist range of motion, psychological status (Hospital Anxiety and Depression Scale or HADS), pain (Numeric Rating Scale or NRS), and self-perceived disability (Disabilities of the Arm, Should, and Hand or DASH) were taken at baseline, cast removal, and 24weeks. Differences in outcomes between time points were determined using analysis of variance. Multiple linear regressions were used to determine predictors of pain and disability at 24weeks. One hundred forty patients with DRF (70% women, age: 67.0 ± 17.9) completed 24weeks of follow-up and were included in the analysis. NRS (off-cast), range of ulnar deviation (off-cast), and greater occupational demands were significant predictors of pain at week 24 (adjusted R2 = 0.331, p < 0.001). Significant predictors of perceived disability at week 24 were HADS (off cast), sex (female), dominant-hand injury, and range of ulnar deviation (off cast) (adjusted R2 = 0.265, p < 0.001). Off-cast NRS and HADS scores are important modifiable predictors of patient-reported pain and disability at 24weeks in patients with DRF. These factors should be targeted in the prevention of chronic pain and disability post-DRF.

Prevalence and determinants of musculoskeletal pain among school-going children carrying schoolbags: A cross-sectional study from Central India.

ABSTRACTMusculoskeletal disorders constitute 1,194 prevalent cases per 1,00,000 among children aged 5 to 19 years in India. School bags with a weight exceeding 10% of the bodyweight is a common cause of backache in school children.Methods:School children aged 8–15 years from four private schools of Bhopal were included, resulting in a sample of 934 participants. An author-assisted questionnaire was used for data collection.Results:The school bags were 16.5% of the average weight of students. 55.9% of the students experienced pain in the last 12 months, 41.6% in the last ten days and 21.3% had visited a doctor for the same. On analysis, bags with ³ three compartments (AOR: 3.7), using both shoulders to carry bags (AOR: 0.10), and the absence of lockers in schools (AOR: 17.80) were significant predictors of pain in the last ten days (P < 0.05).Conclusion:Massive advocacy and orientation are required at all levels for educational administrators, teachers, parents and students.

A Mediation Appraisal of Catastrophizing, Pain-Related Outcomes, and Race in Adults With Knee Osteoarthritis

The current cross-sectional study investigates whether pain catastrophizing mediates the relationship between ethnicity/race and pain, disability and physical function in individuals with knee osteoarthritis. Furthermore, this study examined mediation at 2-year follow-up. Participants included 187 community-dwelling adults with unilateral or bilateral knee pain who screened positive for knee osteoarthritis. Participants completed several self-reported pain-related measures and pain catastrophizing subscale at baseline and 2-year follow-up. Non-Hispanic Black (NHB) adults reported greater pain, disability, and poorer functional performance compared to their non-Hispanic White (NHW) counterparts (Ps < .05). NHB adults also reported greater catastrophizing compared to NHW adults. Mediation analyses revealed that catastrophizing mediated the relationship between ethnicity/race and pain outcome measures. Specifically, NHB individuals reported significantly greater pain and disability, and exhibited lower levels of physical function, compared to NHW individuals, and these differences were mediated by higher levels of catastrophizing among NHB persons. Catastrophizing was a significant predictor of pain and disability 2-years later in both ethnic/race groups. These results suggest that pain catastrophizing is an important variable to consider in efforts to reduce ethnic/race group disparities in chronic pain. The findings are discussed in light of structural/systemic factors that may contribute to greater self-reports of pain catastrophizing among NHB individuals. PerspectiveThe current study examines whether pain catastrophizing mediates the relationship between ethnicity/race and OA-related pain, disability, and functional impairment at baseline and during a 2-year follow-up period in non-Hispanic Black and non-Hispanic White adults with knee pain. These results point to the need for interventions that target pain catastrophizing.

Psychological Factors Are Associated with Pain at All Time Frames After Breast Cancer Surgery: A Systematic Review with Meta-Analyses.

This systematic review aimed to 1) assess associations between psychological factors and pain after breast cancer (BC) treatment and 2) determine which preoperative psychological factors predicted pain in the acute, subacute, and chronic time frames after BC surgery. A systematic review with meta-analysis. Women with early-stage BC. The Medline, EMBASE, CINAHL, and Web of Science databases were searched between 1990 and January 2019. Studies that evaluated psychological factors and pain after surgery for early-stage BC were included. Associations between psychological factors and pain, from early after surgery to >12 months after surgery, were extracted. Effect size correlations (r equivalents) were calculated and pooled by using random-effects meta-analysis models. Of 4,137 studies, 47 were included (n = 15,987 participants; 26 studies ≤12 months after surgery and 22 studies >12 months after surgery). The majority of the studies had low to moderate risk of bias. Higher preoperative anxiety and depression were weak but significant predictors of pain at all time points up to 12 months (r equivalent: 0.15-0.22). Higher preoperative pain catastrophizing and distress were also weak but significant predictors of pain during the acute (0-7 days) and chronic (3-12 months) periods (r equivalent: 0.10-0.20). For the period >12 months after surgery, weak but significant cross-sectional associations with pain were identified for anxiety, depression, pain catastrophizing, and distress (r equivalents: 0.15, 0.17, 0.25, 0.14, respectively). Significant pooled effect size correlations between psychological factors and pain were identified across all time frames. Though weak, these associations should encourage assessment of key psychological factors during preoperative screening and pain assessments at all postoperative time frames.

Time of Evaluation of Pain Catastrophizing after Surgery for Upper Extremity Motor Disorders.

Background: The evaluation of pain catastrophizing, which is a negative emotion associated with pain, is useful for predicting pain after surgery and is also associated with upper extremity disability. Therefore, it is important to evaluate pain catastrophizing after surgery for upper limb musculoskeletal disorders. This study examined the appropriate time to evaluate pain catastrophizing after surgery for upper extremity motor disorders. Methods: A total of 32 patients underwent surgery. Pain catastrophizing (Pain Catastrophizing Scale: PCS) and pain intensity (Numerical Rating Scale: NRS) were measured at the start of rehabilitation and 2, 4, and 8 weeks postoperatively. The subjective ability of the upper extremity was measured 8 weeks postoperatively using the Hand20 questionnaire. The variation in the postoperative PCS and NRS were investigated. Results: The PCS and NRS values were significantly lower 2 weeks postoperatively than at the time rehabilitation started. Pain catastrophizing was a significant predictor of pain, with the greatest degree of prediction at 2 weeks. Pain catastrophizing was also a significant predictor of the Hand20 result at 8 weeks postoperatively. Conclusions: Our data shows that pain catastrophizing should be evaluated 2 weeks postoperatively for the prediction of continuing pain.

Factors Related to Pain in Patients With Retorn Rotator Cuffs: Early Postoperative Pain Predicts Pain at 12 Months Postoperatively.

Background:Retearing of a repaired rotator cuff leads to diverse symptoms, including pain, regardless of the degree of the tear, but the relationship between pain and retears is poorly understood.Purpose:To determine which factors are correlated with shoulder pain in retears of a repaired rotator cuff.Study Design:Case-control study; Level of evidence, 3.Methods:We retrospectively reviewed a cohort of patients who were diagnosed as having a retear on magnetic resonance imaging after primary rotator cuff repair. The primary outcome variable of interest was the visual analog scale (VAS) for pain score at 12-month and final follow-up (mean, 25.2 months). We evaluated the relationship of pain at 12-month and final follow-up with preoperative patient factors (age, sex, and underlying conditions), preoperative range of motion, and preoperative pain; postoperative pain at 3 and 6 months; and perioperative conditions (tear extent, tear size, accompanying lesions, and procedures other than rotator cuff repair).Results:A total of 48 patients were reviewed. The VAS score at 3 months postoperatively showed a positive correlation with the VAS score at 12 months postoperatively (ρ = 0.537; P < .001) and at final follow-up (ρ = 0.537; P < .001). Univariate and multivariate regression analyses revealed that the VAS score at 3 months postoperatively (P = .0001 and P = .0017, respectively), hypertension (P = .0108 and P = .0073, respectively), and late detection of the retear (P = .0091 and P = .0208, respectively) were significant predictors of pain at 12 months postoperatively.Conclusion:The presence of pain in the early postoperative period, underlying hypertension, and late detection of the retear were related to pain severity in patients 12 months after rotator cuff surgery.

Perioperative Opioid Use Predicts Postoperative Opioid Use and Inferior Outcomes After Shoulder Arthroscopy

The purpose of this study is to define the impact of preoperative opioid use on postoperative opioid use, patient-reported outcomes, and revision rates in a cohort of patients receiving arthroscopic shoulder surgery. Patients who underwent shoulder arthroscopy were identified from an institutional database. Inclusion criteria were completion of preoperative and postoperative patient-reported outcome measures (PROMs) at 1-year follow-up and completion of a questionnaire on use of opioids and number of pills per day. Outcomes assessed included postoperative PROM scores, postoperative opioid use, persistent pain, and achievement of the patient acceptable symptomatic state. A matched cohort analysis was performed to evaluate the impact of opioid use on achievement of postoperative outcomes, whereas a multivariate regression was performed to determine additional risk factors. Receiver operating characteristic curves were used to establish threshold values in oral morphine equivalents (OMEs) that predicted each outcome. A total of 184 (16.3%) patients were included in the opioid use (OU) group and 1,058 in the no opioid use (NOU) group. The OU and NOU groups showed statistically significant differences in both preoperative and postoperative scores across all PROMs (P < .001). Multivariate logistic regression identified preoperative opioid use as a significant predictor of reduced achievement of the patient acceptable symptomatic state (odds ratio [OR], 0.69, 95% confidence interval [CI], 0.29-0.83, P= .008), increased likelihood of endorsing persistent pain (OR, 1.73, 95% CI, 1.17-2.56, P= .006), and increased opioid use at 1 year (OR, 21.3, 95% CI, 12.2-37.2, P < .001). Consuming a high dosage during the perioperative period increased risk of revision surgery (OR, 8.59, 95% CI, 2.12-34.78, P < .003). Results were confirmed by matched cohort analysis. Receiver operating characteristic analysis found that total OME >1430 mg/d in the perioperative period (area under the curve, 0.76) and perioperative daily OME >32.5 predicted postoperative opioid consumption (area under the curve, 0.79). Patients with a history of preoperative opioid use can achieve significant improvements in patient-reported outcomes after arthroscopic shoulder surgery. However, preoperative opioid use negatively impacts patients' level of satisfaction and is a significant predictor of pain and continued opioid usage. Level III, retrospective cohort study.

Predicting musculoskeletal symptoms in workers of a manufacturing company

Background. Musculoskeletal symptoms are the leading factor responsible for sickness absence. Factors associated with the development of musculoskeletal symptoms must be identified and addressed. Objective. To investigate the 7-day prevalence of musculoskeletal symptoms by body regions, and assess the contribution of individual, lifestyle and occupational risk factors to the development of musculoskeletal disorders. Methods. The sample comprised 202 white-collar and blue-collar workers. Musculoskeletal symptoms were assessed with the Nordic questionnaire, and physical activity level and sitting time with the international physical activity questionnaire. Statistical analyses were conducted to assess the associations between individual, lifestyle and occupational category factors and musculoskeletal symptoms. Results. The 7-day prevalence of work-related musculoskeletal symptoms was 41.6% (n = 84). The highest prevalence of symptoms was reported in the lower back (18.8%), followed by the wrists/hands (17.3%), neck (15.8%), shoulder (15.3%) and ankles/feet (11.4%). A significant association was found between reporting musculoskeletal symptoms and work category. In addition, musculoskeletal symptoms were reported more often by older workers. Work category was a significant predictor of pain in the lower back and shoulder regions, and gender was a significant predictor for neck pain. Conclusions. Our results emphasize the need for worksite interventions to prevent musculoskeletal symptoms in this population.

A Cross-sectional Study of Gender-related Differences in Reporting Fatigue and Pain among Latino/A Migrant Farmworkers

ABSTRACT Objectives: Migrant farmworkers face many hardships in both their working and living environments including dangerous and demanding tasks, long hours, and inadequate rest. This study sought to explore gender differences in the reporting of fatigue and pain and to identify predictors of fatigue and pain among migrant farmworkers in Nebraska (n = 241). Methods: Bivariate tests were used to assess associations among study variables. Linear and generalized linear mixed effect models were used to assess gender as a predictor of fatigue and pain respectively while controlling for covariates. Results: Females reported significantly higher levels of fatigue (M score = 15.5, SD = 6.1 compared to M score = 12.8, SD = 4.3) than their male counterparts. Females were also more likely to report pain (56.9% of females compared to 36.3% of males). Being female, pain, hours of sleep, and job demands were significant predictors of fatigue. Fatigue and job-related injury were the only significant predictors of pain. Conclusions: There are gender-related disparities in the reporting of fatigue and pain among Latino/a migrant farmworkers. Extra precautions need to be taken to protect worker health and safety and reduce fatigue, particularly for female workers. Implications for employers, supervisors, and healthcare providers are discussed.

Preoperative Anxiety Levels and Pain during Cataract Surgery

ABSTRACTPurpose: To evaluate the correlation between pain during cataract surgery and preoperative anxiety.Methods: This prospective observational masked study included 103 eyes of 103 consecutive patients who underwent routine clear corneal incision phacoemulsification surgery at the Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel. Patients were interviewed prior to surgery and 5 min following surgery by two separate independent interviewers. Anxiety level was measured by the Visual Analog Scale for Anxiety (VASA) and pain by the Visual Analog Scale (VAS). The main outcome measure was the maximum amount of pain endured during the procedure using VAS.Results: The mean participant age was 68.9 ± 8.9 years, and 46.6% were male. Severe anxiety (VASA ≥ 7) and pain (VAS ≥ 7) were documented in 18.5 and 17.5% of patients, respectively. There was a statistically significant positive correlation between VAS and VASA (r = 0.62, p < .001) as well as between VAS and duration of surgery (r = 0.20, p = .04). There was no association between VAS and all other investigated parameters in the univariate analysis. In backward regression analysis, VASA was the only parameter that was significantly associated with VAS (R2 = 36.61%, p < .001). Patients with severe anxiety were >10 times more likely to experience severe pain, and a VASA > 4 predicted severe pain with a sensitivity of 88.9% and a specificity of 69.4%.Conclusions: One-fifth of patients experienced severe anxiety and pain. Preoperative anxiety levels were the only significant predictor of pain. Reducing preoperative anxiety in cataract patients is warranted.

Factors Influencing Early Postoperative Recovery After Laparoscopic Cholecystectomy

PurposeTo study the factors influencing early postoperative recovery after laparoscopic cholecystectomy. DesignA nonexperimental retrospective study. MethodsThe study was performed using records from all patients who had undergone laparoscopic cholecystectomy at a hospital in Northern Sweden in 2017 (219 patients in total). Nonparametric data were analyzed using Spearman's rho, Mann-Whitney U test, and logistic regression. Parametric data were analyzed using Pearson's correlation, an independent t test, and analysis of variance. FindingsThe length of stay in the postanesthesia care unit was not predicted by factors such as age, gender, body mass index, American Society of Anesthesiologists classification, postoperative nausea and vomiting, premedication, or type of surgery. Younger age and high classification level were significant predictors of pain during rest and pain when in motion. No significant predictors of postoperative nausea were found. The majority of study participants experienced little or no pain or nausea. The documentation of pain, nausea, and premedication was inadequate in many cases. ConclusionsNurses in postanesthesia care units should work to preventively identify and address patients’ medical and emotional needs so that optimal conditions for postoperative recovery can be provided.

The relationship between pain at IUD insertion and negative perceptions, anxiety and previous mode of delivery

Objective: The aim of the study was to better understand the relationship between pain during intrauterine device (IUD) insertion and anxiety, negative perceptions of IUDs and previous mode of delivery, in parous women. Methods: We conducted a prospective cohort study between June and September 2018 in 210 women who opted for IUD placement for contraception. Sixty-six women who had previously had only vaginal delivery under epidural analgesia were allocated to the epidural delivery group; 60 women who had previously had at least one vaginal delivery without epidural analgesia were allocated to the vaginal delivery group; and 84 women who had previously had only caesarean delivery were allocated to the caesarean delivery group. Participants’ levels of anxiety before insertion were measured using the Beck Anxiety Inventory; participants’ levels of pain (anticipated pain and pain at the various stages of IUD insertion and 15 min after the procedure) were assessed using a visual analogue scale. Results: While the experience of caesarean delivery and pre-procedure anxiety were found to be associated with higher pain scores, the presence of negative perceptions of IUDs was the most significant predictor of pain during IUD insertion (p < .001). Experience of vaginal delivery under epidural analgesia was associated with lower pain scores at IUD insertion (p < .001). Conclusion: Fear of IUD insertion pain, pre-procedure anxiety and negative perceptions of IUDs may lead women to anticipate or feel a higher level of pain. Patient education to correct negative perceptions of IUDs and counselling to inform women of the true benefits and risks of IUDs and lower pre-procedure anxiety are a suggested strategy to manage IUD insertion pain in parous women.

Prevalence of shoulder morbidity after treatment for breast Cancer in South Africa.

Breast cancer is the most frequently diagnosed cancer and leading cause of cancer death among women, representing a considerable public health burden in South Africa and other low-middle income countries. Short- and long-term complications of these treatments include shoulder morbidities such as pain, decreased range of motion, tightness, weakness, pain, numbness and lymphoedema and may be present for up to 6years post-treatment. An understanding of baseline demographic and clinical risk factors can guide rehabilitation and management strategies for high-risk patients. The aims of this study were to quantify the burden of shoulder pain and disability in a tertiary academic hospital in Cape Town, South Africa, and identify potential risk factors for the development of shoulder morbidity. This study was a cross-sectional analysis of the prevalence of shoulder pain and dysfunction in women attending their post-treatment annual follow-up visit for unilateral breast carcinoma. Three in four patients reported a presence of any pain or disability while only 9% experienced severe pain and disability. Multivariable ordinal logistic regression analysis identified race, side, axillary surgery, chemotherapy and age as significant predictors of pain and chemotherapy a significant predictor of disability. The substantial burden of shoulder morbidity in this population represents a significant public health burden. The use of identified clinical and demographic characteristics may guide in the development of survivorship programmes incorporating surveillance and management of these high-risk patients.

Effects of Mindfulness Training on Sleep Problems in Patients With Fibromyalgia.

Fibromyalgia syndrome (FMS) is a complex psychosomatic pain condition. In addition to generalized pain and various cognitive difficulties, new FMS diagnostic criteria acknowledge fatigue and sleep problems as core aspects of this condition. Indeed, poor sleep quality has been found to be a significant predictor of pain, fatigue, and maladaptive social functioning in this patient group. While there is promising evidence supporting the role of mindfulness as a treatment for FMS, to date, mindfulness intervention studies have principally focused on dimensions of pain as the primary outcome with sleep problems either not being assessed or included as a secondary consideration. Given the role of sleep problems in the pathogenesis of FMS, and given that mindfulness has been shown to improve sleep problems in other clinical conditions, the present study explored the effects of a mindfulness-based intervention known as Flow Meditation (Meditación-Fluir) on a range of sleep-related outcomes (subjective insomnia, sleep quality, sleepiness, and sleep impairment) in individuals with FMS. Adult women with FMS (n = 39) were randomly assigned to the 7 weeks mindfulness treatment or a waiting list control group. Results showed that compared to the control group, individuals in the mindfulness group demonstrated significant improvements across all outcome measures and that the intervention effects were maintained at a 3 month follow-up assessment. The Meditación-Fluir program shows promise for alleviating sleep problems relating to FMS and may thus have a role in the treatment of FMS as well as other pain disorders in which sleep impairment is a central feature of the condition.

Parameters affecting pain, physical function and radiology in patients with hip osteoarthritis: A preliminary report of a multicenter longitudinal study

The aim of this multicentric study is to investigate the characteristics of patients with hip osteoarthritis (HOA) and to assess the relationship of clinical and functional features with radiographic parameters in a Turkish population. A total of 220 subjects with HOA who participated in a multicenter national cohort study were enrolled in this study. Demographic characteristics, as well as duration of pain, pain severity, night pain, Timed Up and Go (TUG) test score were recorded. The self-reported pain and physical function were assessed using the Western Ontario McMaster Universities (WOMAC) Osteoarthritis Index. The X-rays of the hips were assessed by the Kellgren–Lawrence (KL) method. Relationships between parameters were analyzed with bivariate analysis. Analysis of covariance was used to create a model for pain, physical function, and other disease-related parameters. Variables showing a statistically significant correlation were included into ANOVA. The mean age of the patients was 62.1 ± 12.2 years. WOMAC-pain was significantly correlated with female sex, pain severity, night pain, symptom duration, KL score, and TUG test score ( P < 0.05). WOMAC physical function showed a significant correlation with pain severity, night pain, KL score, and TUG test score ( P < 0.05). KL score was significantly correlated with the presence of scoliosis, leg length discrepancy, and TUG test score ( P < 0.05). Factors most strongly affecting WOMAC-pain and function were overall pain severity, night pain severity ( P < 0.05). Factors most strongly affecting KL radiographic grade were TUG test score, leg length discrepancy, and scoliosis ( P < 0.05). In case of disability; overall and night pain severity are significant predictors of pain and function. High TUG test score, scoliosis and leg length discrepancy are better predictors of a high radiographic grade. Since HOA is a multifactorial process, several factors might affect pain, function, and radiographic features. Therefore, clinicians should consider all these factors in patients with HOA.

Sedentary Behavior Predicts Headache Pain Following Mild Traumatic Brain Injury

The acute management of mild traumatic brain injury (mTBI), particularly in athletes, typically includes a period of physical rest during symptom resolution. However, evidence for the use of rest versus physical activity to aid in mTBI recovery is mixed and may depend on symptom type and severity. Post-traumatic headaches (PTH) are one of the most common and long-lasting symptoms of mTBI. While physical activity is often used in the non-pharmacological management of primary headache disorders, the relationship between PTH’s and physical activity behavior in the first month post-injury remains poorly understood. PURPOSE: To determine if self-reported physical activity behavior predicts headache pain in mTBI patients within 1 month of head injury, and whether psychological factors mediate this relationship. METHODS: Twenty-seven mTBI patients recruited from Emergency Departments completed study sessions at 1-2 weeks and 1-month post head injury. The McGill Pain Questionnaire (MPQ) provided a quantitative evaluation of the patient’s headache pain experience. The International Physical Activity Questionnaire - short form assessed the amount of time in the past week participants spent on vigorous and moderate intensity activity, walking, and sitting. Participants also completed the Pain Catastrophizing Scale, which assesses negative mental responses to anticipated or actual pain. Simple and multiple linear regressions were used to test whether physical activity behavior and pain catastrophizing predicted headache pain at 1 month post injury, and whether pain catastrophizing mediated this relationship. RESULTS: Separate simple regression analyses indicated the following: 1) time sitting at 2 weeks post-injury predicted pain on the MPQ at 1 month (B=.41, p=.035), 2) time sitting at 2 weeks predicted pain catastrophizing at 1 month (B=.38, p=.049), 3) pain catastrophizing predicted pain on the MPQ at 1 month (B=.53, p=.003). When pain catastrophizing and time sitting were both entered as predictors into the same regression model, pain catastrophizing was the only significant predictor of pain on the MPQ. CONCLUSIONS: Results suggest that increased sitting in the acute stage of mTBI predicted greater headache pain in the subacute stage of injury, and this relationship was mediated by pain catastrophizing.

Influence of Baseline Psychological Health on Muscle Pain During Atorvastatin Treatment.

3-hydroxy-3-methylglutaryl coenzyme A reductase reductase inhibitors (statins) are generally well tolerated, with statin-associated muscle symptoms (SAMS) the most common side effect (~10%) seen in statin users. However, studies and clinical observations indicate that many of the self-reported SAMS appear to be nonspecific (ie, potentially not attributable to statins). Mental health and well-being influence self-perception of pain, so we sought to assess the effect of baseline well-being and depression on the development of muscle pain with 6 months of atorvastatin 80 mg/d (ATORVA) or placebo in healthy, statin-naive adults. The Psychological General Well-being Index (n = 83) and Beck Depression Inventory (n = 55) questionnaires were administered at baseline in participants (aged 59.5 ± 1.2 years) from the effect of Statins on Skeletal Muscle Function and Performance (STOMP) trial (NCT00609063). Muscle pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), pain that interferes with daily life (Brief Pain Inventory [BPI]), and pain severity (BPI) were then measured before, throughout, and after treatment. At baseline, there were no differences in well-being (Psychological General Well-being Index), depression (Beck Depression Inventory), or pain measures (SF-MPQ and BPI) (P values ≥ .05) between the placebo and ATORVA groups. Baseline well-being correlated negatively with baseline BPI pain severity (r = -0.290, P = .008). Baseline depression correlated with baseline pain (SF-MPQ; r = 0.314, P = .020). Baseline well-being and depression did not predict the change in pain severity or interference after 6 months among the total sample or between groups (P values ≥ .05). Baseline well-being and depression were not significant predictors of pain after 6 months of ATORVA (P values ≥ .05). Thus, they do not appear to increase the risk of SAMS in otherwise healthy adults.