Characterization of biopsychosocial factors of patients with chronic nonspecific low back pain

Rocha, Jessica Roberta de Oliveira; Karloh, Manuela; Santos, Adair Roberto Soares; Sousa, Tatiane Regina de

doi:10.5935/2595-0118.20210062

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…The perception of a painful stimulus associated with chronic pain is followed by cognitive processing and interpretation, leading to various behaviors and responses by those who experience it. This cognitive processing is influenced by personal beliefs, values, and the environment [ 14 ]. Approaching pain from a biopsychosocial model perspective reveals that the early detection of psychosocial factors interfering with pain can alter therapeutic strategies and expedite effective pain treatment.…”

Section: Introductionmentioning

confidence: 99%

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Rodrigues,

Costeira

2024

Nursing Reports

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Pain is a prevalent symptom in patients with chronic kidney disease, related to disease progression, comorbidities, and required immobility during dialysis treatment. Nurses must perform detailed pain assessments to manage pain effectively during hemodialysis treatment. This quality improvement project, reported using SQUIRE 2.0, aims to describe pain characteristics in chronic kidney disease patients in a hemodialysis unit clinic in Portugal, implement strategies to improve the pain assessment process in patients with chronic kidney disease during hemodialysis treatment, and assess nurses’ satisfaction with the implemented strategies. The study was conducted in a Portuguese hemodialysis clinic, with patients and nurses, in three phases: diagnostic study, protocol implementation, and a descriptive study to assess nurse satisfaction. Seventy-five patients (mean age 71 ± 12.6 years) participated, with 64% reporting moderate chronic pain daily and 48% during hemodialysis treatment. Thirteen nurses considered the pain assessment protocol important, rating their satisfaction at 7.92 ± 1.32 (0–10). Standardizing practices through protocol implementation is likely to improve care and increase nurse satisfaction.

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Section: Introductionmentioning

confidence: 99%

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Rodrigues,

Costeira

2024

Nursing Reports

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“…Low back pain (LBP) is a symptom of discomfort or pain located between the costal margin and the lower gluteal fold area and may or may not be associated with irradiation to the lower limb, which occurs in up to 60% of cases. 1,2 Studies show that low back pain is the most common occupational problem in the world, with an incidence of 139 per 100,000 people per year among the general population of the United States. Low back pain has an important socioeconomic impact.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Analysis on Patients After Arthroplasty or Lumbar Arthrodesis

Silva

Rodrigues²,

Lopes

et al. 2023

Coluna/Columna

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Objective: To perform a retrospective analysis of patients with degenerative disc disease of the lumbar spine undergoing arthrodesis or lumbar arthroplasty in terms of functional capacity and quality of life. Methods: Retrospective observational study analyzing the medical records of patients undergoing arthrodesis or lumbar arthroplasty, followed-up at an outpatient clinic from 2018 to 2020. Patient characteristics were evaluated; the quality of life through the results of the Short Form 36 Health Survey Questionnaire (SF-36) and the functional capacity using the Oswestry Disability Index (ODI) in the pre-surgical and post-surgical periods (6 months, 1 and 2 years). The criterion to establish statistical significance was p≤0.05. Results: Sixty-one patients were evaluated. After the surgical interventions, the individuals migrated from the classification of invalid (61.4%-64.6%) to minimal/moderate disability (17.7%-25.6%). There was a decline in ODI scores over time of follow-up (p≤0.001) as well as in SF-36 values (p≤0.001) for all surgical techniques. In this regard, evaluating the difference in means revealed the better performance of lumbar arthroplasty (p≤0.001). Conclusion: The data suggest that lumbar arthroplasty offers greater benefits to patients regarding functional capacity and quality of life. Level of Evidence III; Retrospective, descriptive, observational study.

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“…However, the underlying pathophysiologic mechanisms are still poorly understood. A substantial body of literature exists on the association of biomechanical (12)(13)(14) and psychosocial factors (15)(16)(17) in nsLBP. More recently, the term nociplastic pain has been proposed in the literature (18) to explain the manifestation of neuroplastic maladaptations commonly observed within the nociceptive pathways of nsLBP patients in the absence of verifiable pathology.…”

Section: Introductionmentioning

confidence: 99%

A model for personalized diagnostics for non-specific low back pain: the role of the myofascial unit

Sikdar,

Srbely,

Shah

et al. 2023

Front. Pain Res.

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Low back pain (LBP) is the leading cause of disability worldwide. Most LBP is non-specific or idiopathic, which is defined as symptoms of unknown origin without a clear specific cause or pathology. Current guidelines for clinical evaluation are based on ruling out underlying serious medical conditions, but not on addressing underlying potential contributors to pain. Although efforts have been made to identify subgroups within this population based on response to treatment, a comprehensive framework to guide assessment is still lacking. In this paper, we propose a model for a personalized mechanism-based assessment based on the available evidence that seeks to identify the underlying pathologies that may initiate and perpetuate central sensitization associated with chronic non-specific low back pain (nsLBP). We propose that central sensitization can have downstream effects on the “myofascial unit”, defined as an integrated anatomical and functional structure that includes muscle fibers, fascia (including endomysium, perimysium and epimysium) and its associated innervations (free nerve endings, muscle spindles), lymphatics, and blood vessels. The tissue-level abnormalities can be perpetuated through a vicious cycle of neurogenic inflammation, impaired fascial gliding, and interstitial inflammatory stasis that manifest as the clinical findings for nsLBP. We postulate that our proposed model offers biological plausibility for the complex spectrum of clinical findings, including tissue-level abnormalities, biomechanical dysfunction and postural asymmetry, ecological and psychosocial factors, associated with nsLBP. The model suggests a multi-domain evaluation that is personalized, feasible and helps rule out specific causes for back pain guiding clinically relevant management. It may also provide a roadmap for future research to elucidate mechanisms underlying this ubiquitous and complex problem.

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Characterization of biopsychosocial factors of patients with chronic nonspecific low back pain

Cited by 5 publications

References 34 publications

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Quality of Life Analysis on Patients After Arthroplasty or Lumbar Arthrodesis

A model for personalized diagnostics for non-specific low back pain: the role of the myofascial unit

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