Traumatic Exposure History as a Risk Factor for Chronic Pain in Adult Patients with Sickle Cell Disease

Abstract

This article describes the impact of the integration of a licensed clinical social worker (LCSW) with expertise in behavioral health on identification of risk factors for chronic pain in a cohort of adults with sickle cell disease. Authors conducted a retrospective chart review of all visits to the adult sickle cell center during the first six months of LCSW integration. Demographics, clinical history, and LCSW notes were reviewed. Overall, 71 patients were introduced to the LCSW; 55 percent of them had chronic pain. Patients with chronic pain were older, used opioids daily, took hydroxyurea, reported higher daily pain scores, and underwent more acute care visits and hospitalizations for pain with longer stays. Fifty-eight (81 percent) patients requested concrete social work services such as transportation and housing. Thirty-two patients (55 percent) expressed a desire for mental health counseling while receiving concrete services. Twenty-two (69 percent) of these patients self-disclosed at least one traumatic experience. In fact, a statistically significant relationship between chronic pain and a history of trauma was identified (p = 0.001). Results suggest that sickle cell patients should receive clinical social work services to assess for traumatic exposures that may influence chronic pain.

Pain management in bleeding disorders care: perspectives of Canadian Social Workers in Hemophilia Care

“…Pain is a subjective experience including physical and psychological factors, yet there is support to define pain in purely psychological terms. Biro (2010), for example, moves beyond the strict biological view of pain and acknowledges that pain may exist in psychological form without physical tissue damage present [13] .The biopsychosocial impacts of pain on QoL include relationships [14,15] , work/school, housing, health management [15][16][17] , psychological concerns including depression/anxiety, fatigue or stress [14][15][16]18,19] , and finances (transportation/social services) [14,15,18] .…”

Predicting pain among female survivors of recent interpersonal violence: A proof-of-concept machine-learning approach

“…For example, IPV is related to worse headaches, back pain, pelvic pain, painful intercourse, fibromyalgia, and abdominal pain, and is more generally associated with disabling pain and increased pain severity [7][8][9][10][11][12]. Daily pain complaints are common in the early aftermath of IPV and associated with increased risk for chronic pain development [13][14][15][16]. Although there is a strong association between IPV exposure and risk for chronic pain, under what circumstances and to what extent IPV exposure leads to chronic pain is highly variable [5,7,10].…”

Sexual violence as a precipitator of chronic pain in young adults with sickle cell disease

“…3 Despite Works et al categorizing sexual abuse as a common traumatic experience, no study has explicitly evaluated the relationship between sexual violence as a source of trauma and chronic pain in individuals with SCD. 3 Guidelines for treating individuals with SCD urge for routine screening of depression and anxiety, but not for sexual violence-related trauma, a risk factor for opioid disorder disease. 1 In case 1, in 2015, an 18-year-old individual with hemoglobin SS was the victim of a sexually violent trauma that was not revealed to the SCD team until 2 years after the event when the patient was interviewed about the gradual change in their health care utilization.…”