Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study

Skatteboe, Sigrid; Røe, Cecilie; Fagerland, Morten Wang; Granan, Lars-Petter

doi:10.1186/s12891-016-1386-z

Cited by 20 publications

(17 citation statements)

References 33 publications

(46 reference statements)

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“…We found an alignment of previous pain history and expectations, and that a combination of these led to a new factor showing an association with outcome. This is in line with other studies showing that both an unfavourable pain history and having pessimistic expectations are of importance in predicting poor outcome (Bishop, Mintken, Bialosky, & Cleland, 2013;Kongsted et al, 2014;McDevitt et al, 2018;Mondloch et al, 2001;Myhrvold et al, 2019;Skatteboe et al, 2017a). However, based on AUC of the 3 presented prediction models, the prognostic information explained by the 4 categories appears to supplement other prognostic factors.…”

Section: Future Implicationssupporting

confidence: 90%

Visual trajectory pattern as prognostic factors for neck pain

Myhrvold

Irgens

Robinson

et al. 2020

European Journal of Pain

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Background A novel approach capturing both temporal variation and pain intensity of neck pain is by visual trajectory patterns. Recently, both previous and expected visual trajectory patterns were identified as stronger predictors of outcome than traditional measures of pain history and psychological distress. Our aim was to examine patient characteristics within the various previous and expected patterns, relationship between the two patterns and predictive value of a variable combining the previous and expected patterns. Methods Patients with neck pain (n = 932) consulting chiropractors were included. Baseline measures included pain intensity, disability, psychological variables and symptom history and expectations. Participants reported global perceived effect after 12 weeks. Analyses included descriptive statistics and logistic regression. Results Pain intensity, disability, psychological and worse outcome expectations increased from a single pain episode to severe ongoing pain of previous and expected patterns. Having a severe pain history was associated with poor prognosis, particularly if combined with negative expectations. The variable combining previous and expected patterns had a discriminative ability similar to that of other predictors AUC = 0.64 (95% CI = 0.60–0–67) versus AUC = 0.66 (95% CI = 0.62–0.70). The model with highest discriminative ability was achieved when adding the combined patterns to other predictors AUC = 0.70 (95% CI = 0.66–0.73). Conclusion The study indicates that pain expectations are formed by pain history. The patients’ expectations were similar to or more optimistic compared with their pain history. The prognostic ability of the model including a simplified combination of previous and expected patterns, together with a few other predictors, suggests that the trajectory patterns might have potential for clinical use. Significance The dynamic nature of neck pain can be captured by visual illustrations of trajectory patterns. We report, that trajectory patterns of pain history and future expectations to some extent are related. The patterns also reflect a difference in severity assessed by higher degree of symptoms and distress. Moreover, the visual trajectory patterns predict outcome at 12‐weeks. Since the patterns are easily applicable, they might have potential as a clinical tool.

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Section: Future Implicationssupporting

confidence: 90%

Visual trajectory pattern as prognostic factors for neck pain

Myhrvold

Irgens

Robinson

et al. 2020

European Journal of Pain

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“…The impact of CFs as trigger of placebo and nocebo effects on pain outcome has been quantified in different ways and has been reported in a wide range of musculoskeletal conditions such as low back pain [ 86 – 108 ], neck pain [ 95 , 99 , 109 – 111 ], shoulder pain [ 95 , 112 , 113 ], osteoarthritis [ 38 , 91 , 99 , 100 , 114 – 125 ], rheumatoid arthritis [ 126 ], and fibromyalgia [ 97 , 127 – 132 ].…”

Section: Clinical Relevance Of the Contextual Factorsmentioning

confidence: 99%

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Rossettini

Carlino

Testa

2018

BMC Musculoskelet Disord

194

172

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Placebo and nocebo effects are embodied psycho-neurobiological responses capable of modulating pain and producing changes at different neurobiological, body at perceptual and cognitive levels. These modifications are triggered by different contextual factors (CFs) presented in the therapeutic encounter between patient and healthcare providers, such as healing rituals and signs. The CFs directly impact on the quality of the therapeutic outcome: a positive context, that is a context characterized by the presence of positive CFs, can reduce pain by producing placebo effects, while a negative context, characterized by the presence of negative CFs, can aggravate pain by creating nocebo effects. Despite the increasing interest about this topic; the detailed study of CFs as triggers of placebo and nocebo effects is still lacked in the management of musculoskeletal pain.Increasing evidence suggest a relevant role of CFs in musculoskeletal pain management. CFs are a complex sets of internal, external or relational elements encompassing: patient’s expectation, history, baseline characteristics; clinician’s behavior, belief, verbal suggestions and therapeutic touch; positive therapeutic encounter, patient-centered approach and social learning; overt therapy, posology of intervention, modality of treatment administration; marketing features of treatment and health care setting. Different explanatory models such as classical conditioning and expectancy can explain how CFs trigger placebo and nocebo effects. CFs act through specific neural networks and neurotransmitters that were described as mediators of placebo and nocebo effects.Available findings suggest a relevant clinical role and impact of CFs. They should be integrated in the clinical reasoning to increase the number of treatment solutions, boosts their efficacy and improve the quality of the decision-making. From a clinical perspective, the mindful manipulation of CFs represents a useful opportunity to enrich a well-established therapy in therapeutic setting within the ethical border. From a translational perspective, there is a strong need of research studies on CFs close to routine and real-world clinical practice in order to underline the uncertainty of therapy action and help clinicians to implement knowledge in daily practice.

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“…Case management had also the lowest delity at provider and worker levels. It is possible that the lack of delity at provider level demotivated the nursing staff, decreasing their expectations, and reducing the delity at worker level and outcomes [47].…”

Section: Discussionmentioning

confidence: 99%

Process Evaluation of a Complex Workplace Intervention to Prevent Musculoskeletal Pain in Nursing Staff: Results From INTEVAL_Spain.

Soler-Font

Ramada

Merelles

et al. 2021

Preprint

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Background: The nursing staff is an occupational group at high risk of musculoskeletal pain. Scientific evidence has shown that multifaceted interventions are more effective than those based on a single component to prevent musculoskeletal pain. INTEVAL_Spain was a complex workplace intervention to prevent and manage musculoskeletal pain among nursing staff. Objectives: This study performed a process evaluation of INTEVAL_Spain and aimed to examine whether the intervention was conducted according to the protocol, to investigate the fulfilment of expectations and the satisfaction of workers.Methods: The intervention was a two-armed cluster randomized controlled trial and lasted one year. The process evaluation included quantitative and qualitative methods. Quantitative methods were used to address the indicators of Steckler and Linnan’s framework. Data on recruitment was collected through a baseline questionnaire for the intervention and the control group. Reach and dose received were collected through participation sheets, dose delivered and fidelity through internal registries, and fulfilment of expectations and satisfaction were collected with two questions at 12-months follow-up. Qualitative methods were used for a content analysis of discussion groups at the end of the intervention led by an external moderator to explore satisfaction and recommendations. The general communication and activities were discussed, and final recommendations were agreed on. Data were synthesized and results were reported thematically.Results: The study was performed in two Spanish hospitals during 2016-2017 and 257 workers participated. Recruitment was 62% and 51% for the intervention and the control group, respectively. The reach of the activities ranged from 96% for participatory ergonomics to 5% for healthy diet. The number of sessions offered ranged from 60 sessions for Nordic walking to one session for healthy diet. Fidelity of workers ranged from 100% for healthy diet and 79% for participatory ergonomics, to 42% and 39% for Nordic walking and case management, respectively. Lowest fidelity of providers was 75% for case management and 82% for Nordic walking. Fulfilment of expectations and satisfaction ranged from 6.6/10 and 7.6/10, respectively, for case management to 10/10 together for the healthy diet session. Discussion groups revealed several limitations for most of the activities, mainly focused on a lack of communication between the Champion (coordinator) and the workers. Conclusions: This process evaluation showed that the implementation of INTEVAL_Spain was predominantly carried out as intended. Process indicators differed depending on the activity. Several recommendations to improve the intervention implementation process are proposed.Study registration: ISRCTN15780649

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Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study

Cited by 20 publications

References 33 publications

Visual trajectory pattern as prognostic factors for neck pain

Visual trajectory pattern as prognostic factors for neck pain

Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain

Process Evaluation of a Complex Workplace Intervention to Prevent Musculoskeletal Pain in Nursing Staff: Results From INTEVAL_Spain.

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