Pain Is a Common Problem Affecting Clinical Outcomes in Adults With Cystic Fibrosis

Hayes, Margaret M.; Yaster, Myron; Haythornthwaite, Jennifer A.; Riekert, Kristin A.; McMillan, Kristen Nelson; White, Elizabeth; Mogayzel, Peter J.; Lechtzin, Noah

doi:10.1378/chest.11-0132

Cited by 42 publications

(80 citation statements)

References 17 publications

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“…In a survey on pain including 239 Italian adults with CF, 22.2% used non-pharmacological remedies including massage [8]. Hayes reported that 45% of 83 adult CF patients practiced chiropractic, yoga or massage for pain relief [6]. In a study of 97 pediatric CF patients, 77% used some method of CAM including manipulative techniques [15].…”

Section: Discussionmentioning

confidence: 99%

“…CF patients frequently complain of pain, mainly back pain, chest pain and headache [4]–[11]. Although pain in adults with CF is associated with lower QOL [5]–[6], [11], increased risk of exacerbation [6] and decreased survival [6], [12], it is often neglected by the treating physicians [5], [8]. In addition to drug treatment, many patients with CF use non-drug treatments and complementary and alternative medicine (CAM) [5]–[6], [8], [13]–[15] including osteopathic manipulative treatment (OMT).…”

Section: Introductionmentioning

confidence: 99%

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Impact of Osteopathic Treatment on Pain in Adult Patients with Cystic Fibrosis – A Pilot Randomized Controlled Study

et al. 2014

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BackgroundPain is a common complication in patients with cystic fibrosis (CF) and is associated with shorter survival. We evaluated the impact of osteopathic manipulative treatment (OMT) on pain in adults with CF.MethodsA pilot multicenter randomized controlled trial was conducted with three parallel arms: OMT (group A, 16 patients), sham OMT (sham treatment, group B, 8 patients) and no treatment (group C, 8 patients). Medical investigators and patients were double-blind to treatment for groups A and B, who received OMT or sham OMT monthly for 6 months. Pain was rated as a composite of its intensity and duration over the previous month. The evolution of chest/back pain after 6 months was compared between group A and groups B+C combined (control group). The evolution of cervical pain, headache and quality of life (QOL) were similarly evaluated.ResultsThere was no statistically significant difference between the treatment and control groups in the decrease of chest/back pain (difference = −2.20 IC95% [−4.81; 0.42], p = 0.098); also, group A did not differ from group B. However, chest/back pain decreased more in groups A (p = 0.002) and B (p = 0.006) than in group C. Cervical pain, headache and QOL scores did not differ between the treatment and control groups.ConclusionThis pilot study demonstrated the feasibility of evaluating the efficacy of OMT to treat the pain of patients with CF. The lack of difference between the group treated with OMT and the control group may be due to the small number of patients included in this trial, which also precludes any definitive conclusion about the greater decrease of pain in patients receiving OMT or sham OMT than in those with no intervention.Trial RegistrationClinicalTrials.gov NCT01293019

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of Osteopathic Treatment on Pain in Adult Patients with Cystic Fibrosis – A Pilot Randomized Controlled Study

et al. 2014

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“…Vitamin D deficiency causes muscle weakness and pain in children and adults [27, 28]. Low bone density and osteopenia appear to contribute to chronic pain in patients with cystic fibrosis, and are related to low 25(OH)D levels [29, 30]. …”

Section: The Interface Of Vitamin D and Chronic Painmentioning

confidence: 99%

Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States

Shipton

2015

Pain Ther

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IntroductionA number of studies suggest a link between low levels of 25-hydroxy vitamin D and incidence of acute and chronic pain. Clinical studies of vitamin D supplementation in patients with known vitamin D deficiency have shown mixed results in improving pain scores.MethodsIn this article, vitamin D deficiency risk factors are observed and adequate levels of 25-hydroxy vitamin D defined. Clinical supplementation with vitamin D is explored, including the schedules used in published clinical trials. Evidence of the effectiveness of vitamin D supplementation for the treatment of chronic pain conditions from double-blind randomized controlled trials (RCTs) is examined.ResultsThe scientific evidence for vitamin D as a treatment option for chronic pain is limited due to lack of RCTs. It cannot be stated conclusively that vitamin D deficiency is directly linked to the etiology or maintenance of chronic pain states.ConclusionThere remains a growing body of both clinical and laboratory evidence pointing to a potential relationship between low levels of 25-hydroxy vitamin D and a variety of chronic pain states. More focused research involving large RCTs is necessary.Electronic supplementary materialThe online version of this article (doi:10.1007/s40122-015-0036-8) contains supplementary material, which is available to authorized users.

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“…3 Fears of addiction, respiratory depression, and concern that chronic opioid use complicates lung transplant success can create barriers to appropriate opioid administration. 2,4,5 With multiple medications, therapies, and nutritional supplements required each day, routine care can be physically and emotionally exhausting for CF patients and family members. Adolescents with CF report a high quality of life and they abuse substances less frequently than their healthy counterparts.…”

Section: Morbidity and Death In Cfmentioning

confidence: 99%

“…8 Although many disease-specific therapies can be administered in the home setting, most CF patients die in the hospital setting. 4 This likely reflects a combination of prognostication challenges, reluctance to abandon aggressive therapies, patient/family preference, and caregiving burdens. CF patients may be uniquely suited to Medicaid 'concurrent care' waiver programs in which patients can receive hospice and routine medical care simultaneously.…”

Section: Journal Of Palliative Medicinementioning

confidence: 99%

Palliative Care for Patients with Cystic Fibrosis #265

Estrada-Veras

Groninger²

2013

Journal of Palliative Medicine

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Pain Is a Common Problem Affecting Clinical Outcomes in Adults With Cystic Fibrosis

Cited by 42 publications

References 17 publications

Impact of Osteopathic Treatment on Pain in Adult Patients with Cystic Fibrosis – A Pilot Randomized Controlled Study

Impact of Osteopathic Treatment on Pain in Adult Patients with Cystic Fibrosis – A Pilot Randomized Controlled Study

Vitamin D Deficiency and Pain: Clinical Evidence of Low Levels of Vitamin D and Supplementation in Chronic Pain States

Palliative Care for Patients with Cystic Fibrosis #265

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