Biopsychosocial risk factors for pain and pain-related disability 1 year after surgery for breast cancer

Dams, Lore; Gucht, Elien Van der; Haenen, Vincent; Lauwers, Magalie; Pauw, Sofie De; Steurs, Tinne; Devoogdt, Nele; Smeets, Ann; Bernar, Koen; Vrieze, Tessa De; Groef, An De; Meeus, Mira

doi:10.1007/s00520-022-06805-0

Cited by 9 publications

(7 citation statements)

References 44 publications

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“…Central sensitization is characterized by an increased excitability of central nociceptive circuits, caused by hypersensitivity to sensory inputs, even in the absence of inflammation or other peripheral noxious stimuli [ 87 ]. High scores on the central sensitization scale were positively correlated with high disability in a Dutch study of patients with chronic spinal pain [ 22 ], other musculoskeletal pain disorders [ 21 , 23 ], or pain-related disability after oncological surgery [ 24 ]. Taken together, women with endometriosis who experience high disability may be at risk for central sensitization and at a higher risk for chronification of their pain; therefore, they may benefit from additional therapeutic options with centrally acting treatments, such as pregabalin or duloxetine [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

“…As a result of their chronic pain, women with endometriosis experience a significant increase in physical and mental disabilities, and a decrease in their quality of life compared with that of normative populations [ 2 , 15 , 16 , 17 , 18 , 19 , 20 ]. Moreover, correlations between central sensitization and pain-induced disability have been reported in various chronic pain conditions, such as chronic spinal pain, musculoskeletal pain, and chronic pain in patients with cancer [ 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic

Schwab

Stewen

Kottmann³

et al. 2022

IJERPH

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(1) Background: The main aim of this research was to examine the factors leading to pain-induced disability by assessing the impact of demographic, endometriosis-specific, pandemic-specific, and mental health factors. (2) Methods: Women with endometriosis who attended online support groups were invited to respond to an online survey during the first wave of the COVID-19 pandemic in Germany. The Pain Disability Index (PDI) was employed to assess disability-related daily functioning. Independent predictors of pain-induced disability were determined using univariate and multivariate logistic regression analyses. (3) Results: The mean PDI score of the study population was 31.61 (SD = 15.82), which was significantly higher (p < 0.001) than that reported in a previously published normative study of the German population. In the present study, a high level of pain-induced disability, as defined by scores equal to or higher than the median of the study population, older age (OR 1.063, 95% CI 1.010–1.120, p = 0.020), dysmenorrhea (OR 1.015, 95% CI 1.005–1.026, p = 0.005), dysuria (OR 1.014; 95% CI 1.001–1.027, p = 0.029), lower back pain (OR 1.018, 95% CI 1.007–1.029, p = 0.001), and impaired mental health (OR 1.271, 95% CI 1.134–1.425, p < 0.001) were found to be independent risk factors. Pandemic-specific factors did not significantly influence the pain-induced disability of the participants in this study. (4) Conclusions: The level of pain-induced disability was significantly higher among the women with endometriosis than among women in the normative German validation study. Our findings identified risk factors for experiencing a high level of pain-induced disability, such as demographic and specific pain characteristics. Pandemic-specific factors did not significantly and independently influence the pain-induced disability during the first wave of the COVID-19 pandemic in Germany. Impaired mental health negatively influenced functioning during daily activities. Thus, women with endometriosis should be managed by a multidisciplinary team of healthcare professionals to prevent negative effects of pain-induced disability on their quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic

Schwab

Stewen

Kottmann³

et al. 2022

IJERPH

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“…In fact, maladaptive pain cognitions (e.g., pain‐related worrying) or psychosocial functioning (e.g., anxiety and depression) can enhance or facilitate the transmission of nociceptive stimuli to the brain and may contribute to cognitive emotional sensitization of the somatosensory nervous system, with pain facilitation as a possible consequence (Brosschot, 2002; Fregoso et al, 2019; Glare et al, 2019). Several studies have found that postoperative anxiety, depression, and distress are risk factors for persistent pain after breast cancer surgery (Dams et al, 2022; Schreiber et al, 2021). Maladaptive perceptions and thoughts about pain during or after cancer treatment may contribute to the transition from acute to persistent pain in people surgically treated for breast cancer (Oldenmenger et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

Dams

Gucht

Haenen

et al. 2023

The Anatomical Record

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Pain is one of the most prevalent and long‐term adverse effects described by people who have undergone breast cancer surgery. Non‐helpful perceptions and thoughts about pain may contribute to the transition of acute to persistent pain. Adding educational interventions to the current physical therapy program in this population may help to improve or prevent persistent pain. Pain neuroscience education (PNE) is a type of educational intervention that addresses the experience of pain in a broader sense by explaining pain not only from a biomedical perspective, but also from a psychological and social perspective. A double‐blinded randomized controlled trial (EduCan trial) investigated whether PNE, in addition to a standard physiotherapy program immediately after surgery for breast cancer, was more effective on somatosensory functioning in the short (4 months postoperatively) and long term (18 months postoperatively), than providing a biomedical explanation for pain. Somatosensory functioning was evaluated using a self‐reported questionnaire as well as a comprehensive quantitative sensory testing evaluation. The findings of this study revealed that adding six sessions of PNE to a standard physical therapy program (n = 184) did not result in a significantly different course of somatosensory functioning up to 18 months postoperatively as compared to biomedical pain education. These findings provide an interesting basis for future research into who should receive PNE after surgery for breast cancer (e.g., patient profiling or phenotyping) and how we can tailor it to the individual to increase its effectiveness.

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“…CS has also received attention as a mechanism for cancer pain because CS could affect pain in about 40% of breast cancer survivors [23,24]. Moreover, CS-related symptoms have the capability to predict the intensity and interference of persistent postsurgical pain 1 year after surgery [25,26]. These findings suggest that the assessment and treatment of CS are important for the appropriate treatment and management of cancer pain.…”

Section: Introductionmentioning

confidence: 99%

Central Sensitization in Cancer Survivors and Its Clinical Implications: State of the Art

Nishigami

Manfuku

Lahousse

2023

JCM

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Although the prevalence of cancer pain is 47% after treatment, cancer pain is often underestimated, and many patients are undertreated. The complexity of cancer pain contributes to the lack of its management. Recently, as the mechanism of cancer pain, it has become clear that central sensitization (CS) influences chronic pain conditions and the transition from acute to chronic pain. In this state-of-the-art review, we summarized the association of CS or central sensitivity syndrome with pain and the treatment for pain targeting CS in cancer survivors. The management of patients with CS should not only focus on tissue damage in either the affected body regions or within the central nervous system; rather, it should aim to target the underlying factors that sustain the CS process. Pain neuroscience education (PNE) is gaining popularity for managing chronic musculoskeletal pain and could be effective for pain and CS in breast cancer survivors. However, there is a study that did not demonstrate significant improvements after PNE, so further research is needed. Precision medicine involves the classification of patients into subgroups based on a multifaceted evaluation of disease and the implementation of treatment tailored to the characteristics of each patient, which may play a central role in the treatment of CS.

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Biopsychosocial risk factors for pain and pain-related disability 1 year after surgery for breast cancer

Abstract: Ethics approval: The study was approved by the Ethical Committee of the University Hospitals of Leuven (s60702).Consent to participate: All included patients provided written informed consent.

Cited by 9 publications

References 44 publications

Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic

Determinants of Pain-Induced Disability in German Women with Endometriosis during the COVID-19 Pandemic

Effectiveness of pain neuroscience education on somatosensory functioning after surgery for breast cancer: A double‐blinded randomized controlled trial

Central Sensitization in Cancer Survivors and Its Clinical Implications: State of the Art

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