The contribution of thoracic vertebral deformity and arthropathy to trunk pain in patients with chronic obstructive pulmonary disease (COPD)

Chen, Yi-Wen; Coupal, Tyler M.; Lam, Stephen; Munk, Peter L.; Leipsic, Jonathon; Reid, W. Darlene

doi:10.1016/j.rmed.2018.03.007

Cited by 17 publications

(31 citation statements)

References 40 publications

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“…By 2016, there were 26 papers available as a potential evidence base to the 30 CPGs published between 2010–2015 [46,47,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,92,93,94,95,96,97,98,99,100,101,102]. Across 2017 to 2018, at least another nine studies have been published providing estimates of pain prevalence in people with COPD, which would be available to developers of future CPGs or of CPGs currently underway or being updated [6,19,20,26,31,32,33,34,35].…”

Section: Discussionmentioning

confidence: 99%

“…In people with chronic obstructive pulmonary disease (COPD), persistent pain is a common clinical issue adversely impacting daily function, symptom burden, and quality of life [1,2,3]. To date, there are at least 34 studies [1,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36] and two systematic reviews [2,3] available that report direct estimates of pain prevalence in people with COPD (Figure 1). Prevalence rates for pain vary markedly and range between 21 to 82% (Figure 1) with a mean pooled estimate of 66% (95% Confidence Interval (CI) 44–85%) [2].…”

Section: Introductionmentioning

confidence: 99%

“…Systemic inflammatory processes inherent in COPD are likely to provide the foundation for pain susceptibility [1,3,38]. Previous authors have proposed a range of potential mechanisms that may cause, contribute to, or maintain persistent pain in people with COPD, including altered respiratory and musculoskeletal mechanics [38], postural deviations, osteoporosis, compression fractures [39], vertebral deformation, costovertebral arthropathy, [32], central sensitisation [1,38], side effects of prolonged steroid use [38], the presence of comorbid conditions including anxiety and depression [34], and personal habitus (sex and socioeconomic factors) [33]. For people with COPD attending pulmonary rehabilitation programs, musculoskeletal conditions (e.g., arthritis, back problems, and muscle cramps) have been proposed as the commonest cause of persistent pain, with low back, trunk and neck, and lower extremities described as the most common locations [1,11,32,33,40].…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?

et al. 2019

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Chronic pain is highly prevalent and more common in people with chronic obstructive pulmonary disease (COPD) than people of similar age/sex in the general population. This systematic review aimed to describe how frequently and in which contexts pain is considered in the clinical practice guidelines (CPGs) for the broad management of COPD. Databases (Medline, Scopus, CiNAHL, EMbase, and clinical guideline) and websites were searched to identify current versions of COPD CPGs published in any language since 2006. Data on the frequency, context, and specific recommendations or strategies for the assessment or management of pain were extracted, collated, and reported descriptively. Of the 41 CPGs (English n = 20) reviewed, 16 (39%) did not mention pain. Within the remaining 25 CPGs, pain was mentioned 67 times (ranging from 1 to 10 mentions in a single CPG). The most frequent contexts for mentioning pain were as a potential side effect of specific pharmacotherapies (22 mentions in 13 CPGs), as part of differential diagnosis (14 mentions in 10 CPGs), and end of life or palliative care management (7 mentions in 6 CPGs). In people with COPD, chronic pain is common; adversely impacts quality of life, mood, breathlessness, and participation in activities of daily living; and warrants consideration within CPGs for COPD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?

et al. 2019

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Section: Musculoskeletal Changes Associated With Copdmentioning

confidence: 99%

“…These changes in chest wall rigidity and muscular function may be linked to the postural alterations and changes in rib cage configuration noted in COPD [9,10]. Vertebral deformities have been observed [11,12], with an increase in thoracic kyphosis compared to aged-matched healthy individuals [10,11,12,13,14]. The majority of changes are located in the mid-thoracic and the thoraco-lumbar junction [11,15], which may be related to the prevalence of osteoporosis (9 to 69%) in COPD [16] and its association with kyphotic deformities [17].…”

Section: Musculoskeletal Changes Associated With Copdmentioning

confidence: 99%

The Role of Manual Therapy in Patients with COPD

2019

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Chronic obstructive pulmonary disease (COPD) is a respiratory condition associated with altered chest wall mechanics and musculoskeletal changes. In this narrative review, we describe the underlying musculoskeletal abnormalities in COPD, the reasons for applying manual therapy techniques, their method of application and clinical effects. A variety of manual therapy techniques have been applied in individuals with COPD, including soft tissue therapy, spinal and joint manipulation and mobilisation, and diaphragmatic release techniques. These have been prescribed in isolation and in conjunction with other treatments, including exercise therapy. When applied in isolation, transient benefits in respiratory rate, heart rate and symptoms have been reported. Combined with exercise therapy, including within pulmonary rehabilitation, benefits and their corresponding clinical relevance have been mixed, the extent to which may be dependent on the type of technique applied. The current practical considerations of applying these techniques, including intense therapist–patient contact and the unclear effects in the long term, may limit the broad use of manual therapy in the COPD population. Further high quality research, with adequate sample sizes, that identifies the characteristic features of those with COPD who will most benefit, the optimal choice of treatment approach and the longevity of effects of manual therapy is required.

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Respiratory compromise in French bulldogs presented with intervertebral disc extrusion

Foster,

West,

Butterfield

et al. 2023

Veterinary Record

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BackgroundFrench bulldogs hospitalised for the management of intervertebral disc extrusion (IVDE) are frequently affected by respiratory compromise, typically brachycephalic‐associated upper respiratory obstruction and/or aspiration events. We evaluated the occurrence of such respiratory compromise events in French bulldogs presented to two referral hospitals.MethodsClinical data for French bulldogs diagnosed with IVDE were retrospectively collated, including severity of neurological deficits, neuroanatomical localisation, diagnosis, details of respiratory compromise, treatment and outcome.ResultsA total of 306 dogs diagnosed with IVDE were included. Sixty dogs (19.6%) experienced respiratory compromise, of which 31 dogs (10.1%) progressed to cyanosis, collapse or respiratory arrest.LimitationsThe study was limited by its retrospective nature. Furthermore, the duration of hospitalisation was not evaluated and the decision for euthanasia was often multifactorial.ConclusionOne in five French bulldogs presented with IVDE experienced respiratory compromise. The detrimental welfare effects of this warrant further discussion.

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The contribution of thoracic vertebral deformity and arthropathy to trunk pain in patients with chronic obstructive pulmonary disease (COPD)

Abstract: Trunk pain, at least in part, is caused by thoracic vertebral deformity, and costotransverse and intervertebral arthropathy in patients living with COPD. The results of this study provided the foundation for the management of pain, which requires further exploration.

Cited by 17 publications

References 40 publications

Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?

Systematic Review of Pain in Clinical Practice Guidelines for Management of COPD: A Case for Including Chronic Pain?

The Role of Manual Therapy in Patients with COPD

Respiratory compromise in French bulldogs presented with intervertebral disc extrusion

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