Pain assessment

Haefeli, Mathias; Elfering, Achim

doi:10.1007/s00586-005-1044-x

Cited by 938 publications

(699 citation statements)

References 78 publications

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“…A slider model of VAS is good for measuring pain intensity [14]. It has also proved to correlate with visible and reported signs of pain [35].…”

Section: Discussionmentioning

confidence: 97%

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Pain intensity and severe pain in young immigrant patients with long-standing back pain

Löfvander

Taloyan

2007

Eur Spine J

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The aim of this study was to explore if self-rated pain intensity and severe pain differed significantly between immigrants from different regions, and if other socio-economic, or clinical, characteristics could predict severe pain. A total of 129 men and 217 women at a primary health centre in Stockholm, Sweden, 27-45 years, on long-term sick leave, were recruited in consecutive order and grouped into a Turkish (n = 122), Southern European (n = 52), Middle East (n = 69) and one Mixed (n = 173) group of immigrants. All were employed in service jobs. Somatic status, depression and level of psychosocial stressors, including pain anxiety, were established by standardized procedures. All reported long-standing disabling back pain. Patients rated intensity of pain ''right now'' on a 0-100 mm visual analogue scale (VAS) as a last part of the consultation with two doctors. Severe pain was defined as VAS 75-100. Median values (md) with inter-quartile ranges (IQR) were calculated for interval and ordinal data. Non-parametric statistics were used to calculate significant differences between groups. Crude and age-standardized odds ratios (OR) with 95% confidence intervals (95% CI) as rating severe pain were calculated by binary and forward conditional logistic regression. Men and women were analyzed separately. Women had more tender points, (P \ 0.001), and reported pain anxiety more often (P \ 0.01). Frequency of depression did not differ between the immigrant groups. The VAS-values varied, but not significantly, between the immigrant groups of men and women. Men had lower VAS values than women (md 50, IQR 36-69 vs. md 72, IQR 51-85), (P \ 0.001). Women had a three-fold risk to rate severe pain (OR 2.9, 95% CI 1.8-4.7). By sex, no immigrant group had significantly elevated OR to rate severe pain. Being 40-45 year old doubled the OR as rating severe pain. Men with depression, or little education, had high risks as rating severe pain (age-standardized ORs 4.1; 95% CI 1.7-10.0 and 2.7; 95% CI 1.1-6.8, respectively), and so had depressed women (age-standardized OR 1.9; 95% CI 1.1-3.4). Women with pain anxiety had a doubled, not statistically significant, elevated risk (age-standardized OR 2.0, 95% CI 0.95-4.3). The groups did not differ significantly in pain intensity or severe pain. Severe pain was predicted by depressed mood and probably linked to gender, age and sick roles.

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“…A slider model of VAS is good for measuring pain intensity [14]. It has also proved to correlate with visible and reported signs of pain [35].…”

Section: Discussionmentioning

confidence: 97%

“…Different visual analogue scales (VAS) transfer the subjective experience of pain and help the caregiver ''become aware'' of how strong the pain is perceived [11,14,17,33]. Cultural factors, however, influence styles of communicating pain, which should be regarded when evaluating pain [3].…”

Section: Introductionmentioning

confidence: 99%

Pain intensity and severe pain in young immigrant patients with long-standing back pain

Löfvander

Taloyan

2007

Eur Spine J

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“…Although they were developed for degenerative spinal conditions other than SIJ and the effects of SIJF, the MCID for improvement in chronic back pain is approximately 20 % when measured by VAS [46] and that for ODI is approximately 13-15 points [47]. For EQ-5D, the MCID is less well defined, with changes of 0.15-0.46 reported [44,48].…”

Section: Discussionmentioning

confidence: 99%

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

et al. 2016

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Purpose To compare the safety and effectiveness of minimally invasive sacroiliac joint fusion (SIJF) using triangular titanium implants vs conservative management (CM) in patients with chronic sacroiliac joint (SIJ) pain. Methods 103 adults with chronic SIJ pain at nine sites in four European countries were randomly assigned to and underwent either minimally invasive SIJF using triangular titanium implants (N = 52) or CM (N = 51). CM was performed according to the European guidelines for the diagnosis and management of pelvic girdle pain and consisted of optimization of medical therapy, individualized physical therapy (PT) and adequate information and reassurance as part of a multifactorial treatment. The primary outcome was the difference in change in self-rated low back pain (LBP) at 6 months. Additional endpoints included quality of life using EQ-5D-3L, disability using Oswestry Disability Index (ODI), SIJ function using active straight leg raise (ASLR) test and adverse events. NCT01741025. Results At 6 months, mean LBP improved by 43.3 points in the SIJF group and 5.7 points in the CM group (difference of 38.1 points, p \ 0.0001). Mean ODI improved by 26 points in the SIJF group and 6 points in the CM group (p \ 0.0001). ASLR, EQ-5D-3L, walking distance and satisfaction were statistically superior in the SIJF group. The frequency of adverse events did not differ between groups. One case of postoperative nerve impingement occurred in the surgical group. Conclusions In patients with chronic SIJ pain, minimally invasive SIJF using triangular titanium implants was safe and more effective than CM in relieving pain, reducing disability, improving patient function and quality of life.

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“…Four patients were tested prior to surgery and four patients 3 months after having a LSF. Prior and after each test, the patients were asked to rate their current pain, measured on a numerical rating scale with ''no pain'' at the ''0'' end and ''worst pain possible'' at the ''10'' end of the scale [18,19]. The physical tests were performed on other days than those at which the patients participated in the rehabilitation program.…”

Section: Methodsmentioning

confidence: 99%

The effect of timing of rehabilitation on physical performance after lumbar spinal fusion: a randomized clinical study

et al. 2013

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Background The number of patients undergoing lumbar spinal fusion procedures (LSF) has risen in recent years, but only few studies have examined different rehabilitation strategies for this patient group. Purpose To evaluate the impact of initiating rehabilitation either 6 or 12 weeks after a LSF based on the patients' physical performance using the 6-min walking test (6MWT) and the Å strand Fitness test (AF-test) as measurement. Methods A multicentre RCT including 82 patients with degenerative disc diseases undergoing LSF randomly assigned to initiate rehabilitation either 6 or 12 weeks after surgery. Both groups received the same group-based rehabilitation. The main outcome measures were the 6MWT and the AF-test, secondarily questionnaire-based measures. Follow-up at baseline as well as at 3, 6 and 12 months after surgery.Results Comparing the two groups no statistically significant difference was found in walking distance or fitness over time. In both groups, the patients achieved an overall increase in walking distance (p \ 0.01), but no improvement in fitness. The 6MWT showed significant correlation (-0.37 to -0.59) with the questionnaire-based outcome measures (p \ 0.01). The AF-test did not correlate to either the 6MWT or any of the questionnaire-based outcome measures. Conclusion No difference was found in the effect of initiating rehabilitation either 6 or 12 weeks after LSF on the patients' physical performance in terms of fitness and walking distance. The 6MWT showed fair to moderate correlation to the questionnaire-based outcome measures. The AF-test showed no significant independent value, and we question its use in LSF patients.

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Pain assessment

Cited by 938 publications

References 78 publications

Pain intensity and severe pain in young immigrant patients with long-standing back pain

Pain intensity and severe pain in young immigrant patients with long-standing back pain

Six-month outcomes from a randomized controlled trial of minimally invasive SI joint fusion with triangular titanium implants vs conservative management

The effect of timing of rehabilitation on physical performance after lumbar spinal fusion: a randomized clinical study

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