Physical Activity & Knee OA Pain
Prior research has shown that physical activity may be beneficial for patients with chronic musculoskeletal pain, whereas other studies have found that physical activity can lead to transient increases in pain. Data are lacking on the psychological factors that may amplify or attenuate the impact of physical activity on pain. For a study, patients with knee osteoarthritis (OA) completed questionnaires that assessed pain catastrophizing and reported on daily physical activity and pain intensity for 1 week. Day-to-day increases in physical activity were associated with heightened pain intensity levels. This relationship was stronger in patients with knee OA who had higher levels of catastrophizing when compared with those with lower levels of catastrophizing.
Predicting Long-Term Opioid Therapy
Studies have shown that long-term prescription opioid therapy for chronic non-cancer pain can lead to tolerance and dose escalations in the context of increased pain or opioid misuse, among other complications. Researchers analyzed data on patients presenting to a pain clinic to examine factors on initial patient evaluations that were associated with continued prescription opioid use at 6 months. More than half (51%) of patients were taking opioids at 6 months. Increased self-reported physical functioning was associated with decreased opioid use. Conversely, any prescription opioid use recorded at baseline and aberrant drug-related behaviors were associated with continued opioid use at 6 months.
Characterizing Undiagnosed Neuropathic Pain
The characteristics most strongly associated with screening positive for probable neuropathic pain have not been well defined among patients who have not been diagnosed with this type of pain. Among respondents to a general United States population health survey, about 64% reported pain in the last 12 months, among whom nearly 16% screened positive for probable neuropathic pain, and of those, approximately 69% reported being diagnosed with nerve pain by a healthcare provider. Undiagnosed respondents were significantly more likely to be women and from the South or Midwest. Diagnosed respondents were significantly more likely to report having comorbidities and a number of pain types. Nearly half of undiagnosed respondents reported experiencing pain for more than 5 years.
Undertreated Pain & Dementia in the Elderly
Pain is under-recognized and undertreated in older patients with dementia, according to previous studies. However, few studies have assessed factors associated with pain non-treatment in this patient population. For a study, investigators examined predisposing, enabling, and need characteristics among community-dwelling older adults with mild-to-moderate dementia and clinically significant pain. Participants with higher incomes and greater pain interference were less likely to have non-treatment of pain. A significant interaction between pain interference and depression predicted pain non-treatment only in patients with lower levels of depression. The authors concluded that identifying pain and distress early through behavioral observations may help reduce the burden of pain in older patients with dementia.
Health Literacy Impacts Pain-Related Variables
Numerous investigations have shown that low health literacy is associated with detrimental pain outcomes. However, studies have not established if health literacy impacts other critical pain-related variables, such as catastrophizing and pain self-efficacy. To address this research gap, a study team assessed pre-treatment data among a sample of indigent patients at low-income clinics in rural Alabama. Respondents with lower scores on the Wide Range Achievement Test-4—an achievement test that measures an individual’s ability to read words, comprehend sentences, spell, and compute solutions to math problems—were more likely to experience pain catastrophizing. Scores on the Trouble with Health Information Scale significantly predicted pain self-efficacy. The authors suggest their results highlight the significant association of health literacy with several pain variables.
NEWS FROM APS 2016
MORE FROM APS 2016