Patients With Neck Pain are Less Likely to Improve if They Experience Poor Sleep Quality

Kovacs, Francisco M.; Seco, Jesús; Royuela, Ana; Melis, Sergio; Sanchez, Carlos E.; Díaz-Arribas, María José; Meli, Marcelo; Núñez, Montserrat; Martínez-Rodríguez, María; Fernández, Cristina Gómez; Gestoso, Mario; Mufraggi, Nicole; Moyá, Jordi; Pérez, Vicente Rodríguez; Torres-Unda, Jon; Burgos-Alonso, Natalia; Gago-Fernández, Inés; Abraira, Víctor

doi:10.1097/ajp.0000000000000147

Cited by 20 publications

(19 citation statements)

References 36 publications

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“…[29] With regard to insomnia, the probability of pain improvement decreases as baseline sleep quality decreases in neck pain patients. [30] Campbell et al [31] found that pain catastrophizing moderated the relationship between sleep efficiency and central sensitization in chronic pain patients. Collectively, although the interaction between depression, anxiety, insomnia, and pain catastrophizing is complex and not fully understood, these psychological factors seem to significantly influence pain perception in chronic pain patients, directly or indirectly.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain

Park

Lee²,

Yoon³

et al. 2016

Medicine

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Pain catastrophizing is becoming increasingly recognized as a clinically important psychological factor in chronic musculoskeletal pain. In this retrospective cross-sectional study, we have identified factors associated with an increased risk for pain catastrophizing in chronic neck pain (CNP) patients. We obtained data from our medical database on 331 patients who were treated for neck pain as their chief complaint at our clinic. The Pain Catastrophizing Scale (PCS) was used to define a high pain catastrophizing state (PCS score ≥21) in this study. Patient demographics, pain-related factors, and psychological factors were evaluated with logistic regression analysis to identify risk factors of high pain catastrophizing among patients with CNP. A total of 256 patients with CNP satisfied the study inclusion criteria and were included in the analyses. The median PCS score was 16 (range, 0–45), and 86 of 256 patients (33.5%) reported a PCS score ≥21. In multivariate analysis, high pain intensity, clinical insomnia, and a high level of depression/anxiety were strongly associated with high pain catastrophizing in patients with CNP. Depression was the strongest predictor of high pain catastrophizing, with an odds ratio of 7.35 (95% confidence interval 2.23–24.22). High pain catastrophizing was not significantly related to age, gender, comorbidities, or neck pain-related physical symptoms. In conclusion, poor psychological states should be addressed as an important part of pain management in CNP patients who are susceptible to high pain catastrophizing.

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Section: Discussionmentioning

confidence: 99%

Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain

Park

Lee²,

Yoon³

et al. 2016

Medicine

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“…Future studies in neck pain should incorporate variables reflecting the social domain and other factors that patients perceive as important in their lives (Wiitavaara et al, 2016). Among these are poor sleep quality (Kovacs et al, 2014) , the therapist-patient relationship , expectations of treatment outcome (Skatteboe et al, 2014, economic stress (Palmlof et al, 2012), parental history of musculoskeletal pain (Lier et al, 2014), genetics (Nyman et al, 2011), emotional distress (Johansen et al, 2013), and resilience factors (Sturgeon and Zautra, 2010).…”

Section: Change In Psychological Factorsmentioning

confidence: 99%

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

et al. 2016

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“…Many patients suffering from chronic musculoskeletal pain frequently experience sleep problems even when taking analgesics [ 5 , 6 ]. Because insomnia has been shown to worsen pain, mood, and physical functioning, it could negatively impact the clinical outcomes of patients with chronic musculoskeletal pain [ 7 ]. Insomnia is reported to be significantly associated with increased pain intensity and lowered pain threshold [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis

Park

Yoon

et al. 2016

PLoS ONE

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BackgroundChronic musculoskeletal pain is highly prevalent, disabling, and costly, and has many negative effects on quality of life. The aim of this study was to investigate factors associated with higher reported pain levels in patients with chronic musculoskeletal pain among demographic, clinical, and psychological factors, and to evaluate whether insomnia is independently associated with pain intensity in this population.MethodsA total of 357 patients with chronic musculoskeletal pain (pain duration ≥ six months) satisfied the study inclusion criteria and were included in the analyses. Patient demographics, clinical, and psychological factors were evaluated with hierarchical multivariate logistic analysis to identify factors associated with severe pain (NRS [numeric rating scale] ≥ 7). Hierarchical linear regression analysis also performed to identify factors associated with pain intensity (0 to 10 NRS).ResultsMultivariate logistic analyses revealed older age (OR [odds ratio] = 1.017, 95% CI [confidence interval] 1.001–1.032, P = 0.034), high anxiety level (OR = 1.162, 95% CI 1.020–1.324, P = 0.024), high pain catastrophizing (OR = 1.043, 95% CI 1.007–1.081, P = 0.018), and severe insomnia (OR = 1.112, 95% CI 1.057–1.170, P<0.001) were significantly associated with severe pain. Hierarchical linear regression analysis showed age (β = 0.106, P = 0.041), pain catastrophizing (β = 0.249, P<0.001), and insomnia (β = 0.286, P<0.001) were significantly associated with pain intensity. The variance in pain intensity explained by the final model was 32.2%.ConclusionsOlder age, severe insomnia, and high pain catastrophizing were significantly associated with higher reported pain levels. Insomnia was independently associated with pain intensity, even after controlling for various demographic and clinical factors. These factors should be considered when devising pain management strategies for this population.

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Patients With Neck Pain are Less Likely to Improve if They Experience Poor Sleep Quality

Abstract: NP is less likely to improve in patients with poorer SQ, irrespective of age, sex, catastrophizing, depression, or treatments prescribed for NP. Future studies should confirm these results with more severely impaired patients.

Cited by 20 publications

References 36 publications

Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain

Factors associated with increased risk for pain catastrophizing in patients with chronic neck pain

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment

Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis

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