Chronic pain epidemiology – where do lifestyle factors fit in?

Hecke, Oliver van; Torrance, Nicola; Smith, Blair H.

doi:10.1177/2049463713493264

Cited by 149 publications

(116 citation statements)

References 102 publications

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“…This is a greater proportion than people with asthma (To 2012) or diabetes (IDF 2012) in the same population (van Hecke 2013a). The World Health Organization (WHO) recognises chronic pain as a public health problem throughout the world, with one systematic review assessing the growing evidence that the prevalence of chronic pain in the general population is high internationally (34% in low-income countries and 30% in high-income countries; Elzahaf 2012).…”

Section: Introductionmentioning

confidence: 99%

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Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews

Geneen

Moore²,

Clarke

et al. 2017

Cochrane Database of Systematic Reviews

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533

274

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BackgroundChronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. Chronic pain has a weighted mean prevalence in adults of 20%.For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercise may have specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning.Physical activity and exercise programmes are increasingly being promoted and offered in various healthcare systems, and for a variety of chronic pain conditions. It is therefore important at this stage to establish the efficacy and safety of these programmes, and furthermore to address the critical factors that determine their success or failure.ObjectivesTo provide an overview of Cochrane Reviews of adults with chronic pain to determine (1) the effectiveness of different physical activity and exercise interventions in reducing pain severity and its impact on function, quality of life, and healthcare use; and (2) the evidence for any adverse effects or harm associated with physical activity and exercise interventions.MethodsWe searched theCochrane Database of Systematic Reviews (CDSR) on the Cochrane Library (CDSR 2016, Issue 1) for systematic reviews of randomised controlled trials (RCTs), after which we tracked any included reviews for updates, and tracked protocols in case of full review publication until an arbitrary cut-off date of 21 March 2016 (CDSR 2016, Issue 3). We assessed the methodological quality of the reviews using the AMSTAR tool, and also planned to analyse data for each painful condition based on quality of the evidence.We extracted data for (1) self-reported pain severity, (2) physical function (objectively or subjectively measured), (3) psychological function, (4) quality of life, (5) adherence to the prescribed intervention, (6) healthcare use/attendance, (7) adverse events, and (8) death.Due to the limited data available, we were unable to directly compare and analyse interventions, and have instead reported the evidence qualitatively.Main resultsWe included 21 reviews with 381 included studies and 37,143 participants. Of these, 264 studies (19,642 participants) examined exercise versus no exercise/minimal intervention in adults with chronic pain and were used in the qualitative analysis.Pain conditions included rheumatoid arthritis, osteoarthritis, fibromyalgia, low back pain, intermittent claudication, dysmenorrhoea, mechanical neck disorder, spinal cord injury, postpolio syndrome, and patellofemoral pain. None of the reviews assessed 'chronic pain' or 'chronic widespread pain' as a general term or specific condition. Interventions included aerobic, strength, flexibility, range of motion, and core or balance training programmes, as well as yoga, Pilates, and tai chi.Reviews were well performed an...

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Section: Introductionmentioning

confidence: 99%

“…Other factors associated with chronic pain conditions are modifiable, such as smoking status, alcohol intake, nutrition, obesity, comorbidities, employment status and occupational factors, and physical activity level (Smith 2007; van Hecke 2013a). …”

Section: Introductionmentioning

confidence: 99%

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews

Geneen

Moore²,

Clarke

et al. 2017

Cochrane Database of Systematic Reviews

Self Cite

533

274

View full text Add to dashboard Cite

show abstract

“…Hence, modification of these impairments by lifestyle changes in physical, psychological and social domains could be a considerable aid for pain management and improvement of their quality of lives (38,40).…”

Section: Discussionmentioning

confidence: 99%

Chronic Pain Management and Being Vulnerable in Older People: A Qualitative Study

Manoochehri

Shirazi

Tafreshi

et al. 2014

Jundishapur J Chronic Dis Care

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Background: With respect to high prevalence of chronic pain in the elderly, identifying factors influencing on its management process is very important. Objectives: The present study aimed to understand this management process and its setbacks in the elderly. Materials and Methods: The grounded theory approach using unstructured interviews and observation of participants were the main methods for data collection. Study participants consisted of 30 old people with chronic pain, 3 relatives, and 29 health care providers selected with purposive and theoretical sampling methods in Ahvaz. Sampling was continued until data saturation reached. Data analysis was performed concurrently with data gathering based on Strauss and Corbin's proposed method. Data rigor (trustworthiness) was confirmed by Lincoln and Gubba's approach. Results: Vulnerability was one of major themes extracted as parts of a Grounded Theory study results, which composed of three categories: functional impairment, disability, and limitations. Many participants had functional impairment in their mood and emotional, social, and psychological aspects and encountered a series of disabilities for doing their daily activities. Moreover, they had limitations in physical as well as environmental aspects, all of them influenced their pain management. Conclusions: Chronic pain in the elderly has often been assessed and treated inadequately; therefore, attention to their problems and limitations may be useful in developing a comprehensive caring program and managing effectively their chronic pain.

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“…Pain in patients with multiple comorbidities contributes to impaired well being, poor physical function, depression, quality of care, and health care overutilization (4)(5)(6)(7)(8). Chronic pain is reported to be prevalent in ESRD (9)(10)(11)(12)(13), but is less commonly studied in predialysis CKD (12,13).…”

Section: Introductionmentioning

confidence: 99%

Chronic Pain and Analgesic Use in CKD

Wu¹,

Ginsberg²,

Zhan

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Chronic pain in predialysis CKD is not fully understood. This study examined chronic pain in CKD and its relationship with analgesic usage.Design, setting, participants, & measurements Data include baseline visits from 308 patients with CKD enrolled between 2011 and 2013 in the Safe Kidney Care cohort study in Baltimore, Maryland. The Wong-Baker FACES Pain Rating Scale measured chronic pain severity. Analgesic prescriptions and over-the-counter purchases were recorded up to 30 days before visits, and were classified as a drug-related problem (DRP) based on an analgesic's nephrotoxicity and dose appropriateness at participants' eGFR. Participants were sorted by pain frequency and severity and categorized into ordinal groups. Analgesic use and the rate of analgesics with a DRP were reported across pain groups. Multivariate regression determined the factors associated with chronic pain and assessed the relationship between chronic pain and analgesic usage.Results There were 187 (60.7%) participants who reported chronic pain. Factors associated with pain severity included arthritis, taking $12 medications, and lower physical function. Use of nonsteroidal anti-inflammatory drugs was reported by seven participants (5.8%) with no chronic pain. Mild and severe chronic pain were associated with analgesics with a DRP, with odds ratios of 3.04 (95% confidence interval [95% CI], 1.12 to 8.29) and 5.46 (95% CI, 1.85 to 16.10), respectively. The adjusted rate of analgesics with a DRP per participant increased from the group with none to severe chronic pain, with rates of 0.07 (95% CI, 0.04 to 0.13), 0.12 (95% CI, 0.07 to 0.20) and 0.16 (95% CI, 0.09 to 0.27), respectively.Conclusions Chronic pain is common in CKD with a significant relationship between the severity of pain and both proper and improper analgesic usage. Screening for chronic pain may help in understanding the role of DRPs in the delivery of safe CKD care.

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Chronic pain epidemiology – where do lifestyle factors fit in?

Cited by 149 publications

References 102 publications

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews

Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews

Chronic Pain Management and Being Vulnerable in Older People: A Qualitative Study

Chronic Pain and Analgesic Use in CKD

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