Pain medicine : the official journal of the American Academy of Pain Medicine
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Low back pain (LBP) is a significant issue with considerable impact on people's lives and economies. A plethora of research has investigated interventions to manage LBP. However, despite considerable knowledge translation efforts, individuals with the condition frequently use management strategies considered to be "ineffective." To address this concern, our aim was to explore why people with LBP choose the management strategies they do. ⋯ These outcomes suggest that people with LBP are likely to have nuanced reasons for choosing the management strategies they use, and this can contrast with the outcomes tested in empirical studies. Our findings suggest that researchers may need to broaden or rethink which outcomes they measure and how, including by meaningfully engaging consumers in research design. Furthermore, clinicians could better explore their patients' reasons for using the strategies they do before suggesting they discard existing strategies or offering new ones.
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To examine the prevalence and duration of skeletal muscle relaxant (SMR) treatment among commercially insured adults in the United States. ⋯ SMRs are widely used in the United States. Their use slightly increased in recent years, but trends varied among individual agents, patient groups, and geographic regions. Despite limited evidence to support efficacy, a sizable number of U.S. adults used SMRs for long-term and off-label conditions. Further study is needed to understand determinants of treatment as well as outcomes associated with such use.
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Individuals with obesity frequently contend with chronic pain, but few studies address the clinical impact of coordinated pain services on this population. The current study addresses this topic by comparing the effectiveness of a comprehensive pain rehabilitation program for patients with and without obesity. ⋯ Multidisciplinary pain rehabilitation programs appear to be an effective treatment intervention for patients who have concomitant chronic pain and obesity, to a degree comparable to patients who have chronic pain but do not contend with obesity. Implications for program development, clinical interventions, and future research are discussed.
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Sickle cell disease (SCD) is a genetic disorder that affects approximately 100,000 Americans, the majority of whom are African American. SCD-related pain often has deleterious effects on functioning and quality of life. The inherited nature of SCD, SCD-related stigma, and serious physical and functional impact of SCD-related pain create a situation ripe for individuals to appraise their SCD-related pain as unfair or unjust. The aim of this preliminary investigation is to explore the extent to which pediatric patients with SCD appraise their pain as unjust and how these appraisals relate to functioning. ⋯ These findings suggest that pain-related injustice appraisals are an important contributor to the pain experience of youth with SCD. Early identification and remediation of pain-related injustice appraisals could have long-term functional benefits for youth with SCD.
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In addition to pain, people with complex regional pain syndrome (CRPS) often report inattention to and disengagement from their affected limb (i.e., "neglect-like symptoms"). Understanding how these symptoms relate to other characteristics of CRPS, and chronic pain generally, could provide insights for preventing and treating CRPS. ⋯ This study confirms the specificity of inattention to and disengagement from the affected limb in CRPS, independent of other factors. Furthermore, two components of the Neurobehavioral questionnaire were disentangled: motor and cognitive neglect-like symptoms, and involuntary movements. Results could potentially help clinicians to better assess neglect-like symptoms in chronic pain .