Chronic Pain in Neuromuscular Disease

Miró, Jordi; Gertz, Kevin J.; Carter, Gregory T.; Jensen, Mark P.

doi:10.1016/j.pmr.2012.08.008

Cited by 14 publications

(6 citation statements)

References 47 publications

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“…Although some of these relationships are consistent with previous research4,11 and make intuitive sense (eg, it seems reasonable that pain in the back is the site that is most closely associated with pain interference, because the muscles in the back are involved in almost all actions in which the upper body is involved and many of those in which the activity of the lower body is involved), the possible reasons for the importance of other locations to patient function are less clear. It is difficult to identify a reason as to why pain intensity in the shoulders may be more closely associated with lower psychological function than pain at other sites, for example.…”

Section: Discussionsupporting

confidence: 92%

“…A growing body of evidence indicates that chronic pain is a significant problem for adults with physical disabilities 1–4. Moreover, although information from pediatric populations is scarce, research indicates that chronic pain is also a relevant health issue in youth with physical disabilities 5,6.…”

Section: Introductionmentioning

confidence: 99%

“…For example, pain at certain locations, such as the head in adults with myotonic and facioscapulohumeral dystrophy10 or in the low back and legs in adults with spinal cord injury,11 has been demonstrated to be of greater importance than pain in other body locations in the function of these individuals. Similarly, pain extent – the total number of body areas where pain is experienced – has been found to be associated with function over and above the effects of global pain intensity in adult populations with physical disabilities and chronic pain 4. That is to say, adults who report more than one distinct pain problem or pain in more body locations are likely to also report poorer quality of life and worst function than those with pain in just one location, even when controlling for pain intensity.…”

Section: Introductionmentioning

confidence: 99%

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Pain extent and function in youth with physical disabilities

Miró¹,

Vega²,

Tomé‐Pires³

et al. 2017

JPR

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BackgroundThe aim of this study was to increase our understanding of the role that spatial qualities of pain (location and extent) play in functioning, among youths with disabilities and chronic pain.MethodsOne-hundred and fifteen youths (mean age 14.4 years; SD ±3.3 years) with physical disabilities and chronic pain were interviewed and were asked to provide information about pain locations and their average pain intensity in the past week, and to complete measures of pain interference, psychological function and disability. Most of the participants in this sample were males (56%), Caucasian (68%), and had a cerebral palsy (34%) or muscular dystrophy (25%) problem. Most participants did not report high levels of disability ( X¯=12.7, SD ±9.5, range 0–60) or global pain intensity ( X¯=3.2, SD ±2.4, range 0–10).ResultsPain at more than one body site was experienced by 91% of participants. There were positive associations between pain extent with pain interference (r = 0.30) and disability (r = 0.30), and a negative association with psychological function (r = –0.38), over and above average pain intensity. Additionally, pain intensity in the back (as opposed to other locations) was associated with more pain interference (r = 0.29), whereas pain intensity in the shoulders was associated with less psychological function (r = –0.18), and pain intensity in the bottom or hips was associated with more disability (r = 0.29).ConclusionThe findings support the need to take into account pain extent in the assessment and treatment of youths with physical disabilities and chronic pain, call our attention about the need to identify potential risk factors of pain extent, and develop and evaluate the benefits of treatments that could reduce pain extent and target pain at specific sites.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pain extent and function in youth with physical disabilities

Miró¹,

Vega²,

Tomé‐Pires³

et al. 2017

JPR

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“…Research consistently demonstrates strong associations between the severity of pain and measures of the negative effects of pain on the lives of persons with physical disabilities [1–8]. Chronic pain is a particularly prevalent problem for persons with a spinal cord injury (SCI) [9–21].…”

Section: Introductionmentioning

confidence: 99%

Pain Location and Functioning in Persons With Spinal Cord Injury

Miró

Gertz

Carter³

et al. 2014

PM&R

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Background The influence of pain location and extent on functioning in persons with spinal cord injury (SCI) and chronic pain is not well understood. Objective To investigate the correlations between pain location and extent to determine which pain domains may be important to assess and potentially target in treating chronic pain in SCI populations. Design Prospective, observational study. Setting University medical center. Participants A total of 259 persons with an SCI and chronic pain. Methods Postal mail survey questionnaire. Main Outcome Measurements Pain sites, pain extent (number of sites), pain intensity in specific body locations, pain interference, and physical and psychological functioning. Results A positive association between pain extent and intensity with pain interference (r = 0.33, P < .01) and a negative association with psychological functioning were noted in the study sample (r = −0.21, P < .01). Pain intensity in the lower back and legs (r = 0.55, P < .01) and a number of other sites showed strong associations with patient functioning. Correlation with psychological functioning was significant but weaker (r = −0.22, P < .01 for the lower back and legs). Ambulatory status had only a small moderating effect on the associations between pain intensity in specific sites and pain interference and no effect on psychological functioning. Conclusions The findings support the importance of assessing pain intensity at specific locations as a part of a thorough evaluation of chronic pain, as well as the importance of addressing pain at multiple sites, when managing pain in persons with an SCI.

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“…Studies with samples of adults and youths with chronic pain as a primary presenting problem, as well as with samples of adults or youths with pain secondary to a disability diagnosis, such as neuromuscular disease, cerebral palsy or multiple sclerosis, have shown that pain can impair a person’s cognitive processes 38 , emotional function 39–43 , sleep quality 44 , social and recreational activities 45,46 , and school, work and vocational activities 47 . Our study extends these previous findings by examining a broad range of psychosocial and physical function domains in the same sample.…”

Section: Discussionmentioning

confidence: 99%

Pain Beliefs and Quality of Life in Young People With Disabilities and Bothersome Pain

Miró

Solé

Gertz

et al. 2017

The Clinical Journal of Pain

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Objectives Pain beliefs have been hypothesized to play an important role in pediatric pain. However, research examining the associations between pain-related beliefs and measures of function in youths with disabilities is limited. Methods Eighty-four youths (mean age = 14.26 years; SD = 3.27) with physical disabilities who indicated they also had bothersome pain were interviewed and asked to rate their average pain intensity in the past week, and to complete measures of pain-related beliefs and health-related quality of life. Results A number of pain beliefs were associated with different physical and psychosocial function domains, although different beliefs appeared to play different roles, depending on the function domain examined. Across all of the health-related quality of life domains studied, a belief that pain is influenced by one’s emotions was associated with lower levels of function. No differences were found in pain beliefs related to age. In addition, a small difference in pain beliefs was found for sex; specifically girls were more likely than boys to endorse the belief that pain is influenced by emotions. Discussion The findings provide new information regarding the role that pain beliefs have in predicting function, and have important clinical implications regarding how youth with physical disabilities and pain might be most effectively treated.

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Chronic Pain in Neuromuscular Disease

Cited by 14 publications

References 47 publications

Pain extent and function in youth with physical disabilities

Pain extent and function in youth with physical disabilities

Pain Location and Functioning in Persons With Spinal Cord Injury

Pain Beliefs and Quality of Life in Young People With Disabilities and Bothersome Pain

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