Pain and the global burden of disease

Rice, Andrew S.C.; Smith, Blair H.; Blyth, Fiona

doi:10.1097/j.pain.0000000000000454

Cited by 376 publications

(270 citation statements)

References 25 publications

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“…Chronic pain is a highly prevalent and burdensome problem across the world . An important part of multidisciplinary management of chronic pain is pain biology education designed to help a person re‐conceptualize what pain is, what function it serves, and what biological processes are understood to underpin it .…”

Section: Introductionmentioning

confidence: 99%

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education?

Pate¹,

Veage

Lee

et al. 2019

Pain Practice

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Background Pain education is an important part of multidisciplinary management of chronic pain. The characteristics of people likely to have more improvement in pain biology knowledge following pain education are unknown. Objective To identify the baseline factors predicting changes in pain biology knowledge in adults with chronic pain following a 2‐hour multidisciplinary pain education session. Methods Fifty‐five adults with chronic pain attended a 2‐hour pain education session prior to a multidisciplinary assessment at a pain clinic. Patients completed the 12‐item revised Neurophysiology of Pain Questionnaire (rNPQ, score/12) before and after the pain education session. The primary outcome was change in pain biology knowledge, evaluated with the change in rNPQ score. Ten preselected predictors were investigated using univariate models followed by multivariable models with a manual forwards‐building process. Results Education level and age were significantly associated with change in rNPQ score in the univariate models. Participants with higher levels of education had, on average, 1.96 (0.68 to 3.23) points more improvement in rNPQ score than those with lower levels of education. For every 10 years older a participant was, his or her rNPQ score changed on average by 0.5 (0.1 to 0.8) points less. In the multivariable model, only the education level remained significant, explaining 17% of the variance (R2 = 0.17). The clinical variables that were assessed (pain severity, pain interference, pain self‐efficacy, depression, anxiety, and pain catastrophizing) did not predict any knowledge change. Conclusion This study suggests that, of those patients with chronic pain who choose to attend pain education, more educated patients are more likely to improve their pain biology knowledge after a pain education session.

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Section: Introductionmentioning

confidence: 99%

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education?

Pate¹,

Veage

Lee

et al. 2019

Pain Practice

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“…Karen D. Davis 1,2,3 , Herta Flor 4 , Henry T. Greely 5 , Gian Domenico Iannetti 6 , Sean Mackey 7 , Markus Ploner 8 , Amanda Pustilnik 9,10 , Irene Tracey 11 , Rolf-Detlef Treede 12 and Tor D. Wager 13,14 Abstract | Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain.…”

Section: Brain Imaging Tests For Chronic Pain: Medical Legal and Ethmentioning

confidence: 99%

“…Chronic pain is associated with enormous personal and societal costs; individuals with chronic pain often have a reduced quality of life and unmet therapeutic needs, and society is struggling to cope with the large numbers of people with this condition. Chronic pain affects up to 35% of the population, and costs of medical care and loss of wages and productivity are escalating [5][6][7] . Efforts to improve prevention, treatment and rehabilitation for patients with chronic pain are ongoing.…”

mentioning

confidence: 99%

Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations

et al. 2017

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624 | OCTOBER 2017 | VOLUME 13 www.nature.com/nrneurol CONSENSUS STATEMENT © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d . NeuroethicsA field that studies the implications of neuroscience for human self-understanding, ethics, and policy. Arterial spin labellingAn MRI-based brain imaging technique that detects cerebral blood flow based on magnetic tagging of blood.Nevertheless, diverse groups -including patients, researchers, clinicians, pharmaceutical and medical device companies, insurers and the legal communityseek methods for evaluating chronic pain besides selfreporting. Patients seek objective testing to demonstrate the reality of an invisible condition that is sometimes subject to doubt, researchers seek brain imaging markers that provide scientific, diagnostic and prognostic information that cannot be provided by patient self-reporting, and legal representatives and officials seek techniques to supplement self-reporting and objectively support or challenge claims related to chronic pain. Brain imaging technologies, including functional MRI (fMRI), PET, EEG and magnetoencephalography (MEG), have the potential to provide objective measurements of patterns of brain activity that underlie perceptual experiences (BOX 1). Consequently, some people are looking to brain imaging to provide a window into the experience of chronic pain, particularly because testimony based on fMRI was deemed to be admissible as evidence of pain in a 2015 state trial court in the USA 10,11 . This case was highly publicized, although the judgement was not published so no legal precedent was set, and the grounds on which the fMRI evidence was admitted were criticized by established experts in brain imaging studies of pain 10,11 . In this context, the development of a brain imaging test for chronic pain [12][13][14] has real-world consequences, so appropriate criteria for the use of such a test must be defined. Importantly, the way in which brain imaging evidence might be implemented in legal cases strongly depends on laws that vary greatly between countries. Therefore, examination of the capability of so-called 'pain-o-meter' brain imaging tests is critical, as is consideration of the use of such technology in light of societal views, neuroethics and legal issues. Thus, the aims of this Consensus Statement are to recommend criteria for the evaluation of neuroimaging measures of chronic pain, and to discuss the technical, biological, neuroethical and legal challenges related to establishing brain-based tests for chronic pain. MethodsA presidential task force of the International Association for the Study of Pain (IASP) was established in 2015 to examine the feasibility of a brain-imaging-based diagnostic test for chronic pain. The task force had three purposes: to consider the capacity of brain imaging (in particular fMRI), on the basis of its technical and physiological constraints, to detect whether an individual has chronic pain; to place th...

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“…Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease [6]. In this review, we develop a unifying perspective on the understanding and management of FSS and bodily distress.…”

Section: Introductionmentioning

confidence: 99%

Management of Functional Somatic Syndromes and Bodily Distress

Henningsen

Zipfel²,

Sattel³

et al. 2018

Psychother Psychosom

242

182

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Functional somatic syndromes (FSS), like irritable bowel syndrome or fibromyalgia and other symptoms reflecting bodily distress, are common in practically all areas of medicine worldwide. Diagnostic and therapeutic approaches to these symptoms and syndromes vary substantially across and within medical specialties from biomedicine to psychiatry. Patients may become frustrated with the lack of effective treatment, doctors may experience these disorders as difficult to treat, and this type of health problem forms an important component of the global burden of disease. This review intends to develop a unifying perspective on the understanding and management of FSS and bodily distress. Firstly, we present the clinical problem and review current concepts for classification. Secondly, we propose an integrated etiological model which encompasses a wide range of biopsychosocial vulnerability and triggering factors and considers consecutive aggravating and maintaining factors. Thirdly, we systematically scrutinize the current evidence base in terms of an umbrella review of systematic reviews from 2007 to 2017 and give recommendations for treatment for all levels of care, concentrating on developments over the last 10 years. We conclude that activating, patient-involving, and centrally acting therapies appear to be more effective than passive ones that primarily act on peripheral physiology, and we recommend stepped care approaches that translate a truly biopsychosocial approach into actual management of the patient.

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Pain and the global burden of disease

Cited by 376 publications

References 25 publications

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education?

Which Patients With Chronic Pain Are More Likely to Improve Pain Biology Knowledge Following Education?

Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations

Management of Functional Somatic Syndromes and Bodily Distress

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