Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes

Aasdahl, Lene; Granviken, Fredrik; Meisingset, Ingebrigt; Woodhouse, Astrid; Evensen, Kari Anne I.; Vasseljen, Ottar

doi:10.1186/s12891-021-04332-3

Cited by 15 publications

(13 citation statements)

References 39 publications

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“…Future studies may aim to determine whether short-and long-term clinical outcomes differ by cluster. Homogenous subgroups of patients are clinically relevant as subgroups of patients with musculoskeletal pain, displaying different trajectories of outcomes [24,[27][28][29][30]. While the cluster with the stable personality displayed lower pain and disability during this cross-sectional study, it is unknown if this group would display a greater magnitude of change in clinical outcomes in response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Personality Type and Chronic Pain: The Relationship between Personality Profile and Chronic Low Back Pain Using Eysenck’s Personality Inventory

et al. 2022

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Background: Personality type plays a key role in how individuals respond to a variety of stimuli; however, it is unclear if there is a significant influence on pain perception. While pain is associated with many conditions, chronic low back pain (cLBP) is one of the most prevalent and debilitating problems in modern society. Treating this condition can be a challenge and clinicians must understand all factors that can influence pain perception. Purpose: The present study investigated the relationship between personality type and pain experience in patients experiencing cLBP. Methods: One hundred twenty-four participants completed the Eysenck Personality Inventory (EPI), which identifies two major components of the human personality, neuroticism, and extraversion. Participants also completed the Oswestry Disability Index (ODI), the Tampa Scale for Kinesiophobia (TSK), the Numeric Pain Rating Scale (NPRS), and the Pain Catastrophizing Scale (PCS). The association between pain and personality was determined with a Spearman Rank Correlation Coefficient. A hierarchical cluster analysis with Ward’s clustering method examined for subgroups of individuals based on these variables. Results: The neuroticism score (EPI-N) was found to have a statistically significant relationship with all pain outcome measures. This suggests that people exhibiting a neurotic personality type are likely to have more fear of movement (p = 0.001), greater catastrophizing behavior (p < 0.001), higher self-reported levels of disability (p < 0.001), and higher overall reported levels of pain (p = 0.046) than those with other, more stable personality types. Three clusters were derived with varying levels of pain-related factors and personality. Conclusions: Personality type appears to have an influence on many of the attributes associated with cLBP and may be a useful determinate in both prognosis and interventions.

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Section: Discussionmentioning

confidence: 99%

Personality Type and Chronic Pain: The Relationship between Personality Profile and Chronic Low Back Pain Using Eysenck’s Personality Inventory

et al. 2022

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“…In a study of patients receiving physical therapy for musculoskeletal pain, five phenotypes were identified based on eleven pain-related prognostic factors [ 14 ]. Greater variability in pain, function, and recovery [ 15 ] were observed at fifty-two weeks across phenotypes compared to the anatomical location of pain, suggesting phenotypes more precisely distinguished long-term trajectories [ 14 ]. Numerous studies have identified phenotypes; however, few have prospectively examined their utility in distinguishing short-term clinical outcomes in rehabilitation despite this being a research priority [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain

et al. 2023

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Phenotypes have been proposed as a method of characterizing subgroups based on biopsychosocial factors to identify responders to analgesic treatments. This study aimed to, first, confirm phenotypes in patients with low back pain receiving physical therapy based on an a priori set of factors used to derive subgroups in other pain populations. Second, an exploratory analysis examined if phenotypes differentiated pain and disability outcomes at four weeks of physical therapy. Fifty-five participants completed psychological questionnaires and pressure pain threshold (PPT). Somatization, anxiety, and depression domains of the Symptom-Checklist-90-Revised, and PPT, were entered into a hierarchical agglomerative cluster analysis with Ward’s method to identify phenotypes. Repeated measures ANOVAs assessed pain ratings and disability by phenotype at four weeks. Three clusters emerged: 1) high emotional distress and pain sensitivity (n = 10), 2) low emotional distress (n = 34), 3) low pain sensitivity (n = 11). As an exploratory study, clusters did not differentiate pain ratings or disability after four weeks of physical therapy (p’s>0.05). However, trends were observed as magnitude of change for pain varied by phenotype. This supports the characterization of homogenous subgroups based on a protocol conducted in the clinical setting with varying effect sizes noted by phenotype for short-term changes in pain. As an exploratory study, future studies should aim to repeat this trial in a larger sample of patients.

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“…The identification of this pain phenotype in hand OA may be important as NP has been shown to be associated with greater levels of pain, worse function, greater pain catastrophising thoughts, higher levels of depression, and greater sleep disturbances in OA of other joints [ 7 , 9 ]. Considering that these characteristics are poor prognostic factors for musculoskeletal conditions [ 10 ], it is clear that identifying NP in clinical practice would be useful for clinicians. In addition, previous evidence has shown limited effectiveness of traditional analgesics in NP [ 6 ], suggesting that the first line pharmacological interventions consisting of non-steroidal anti-inflammatories (NSAIDs) and paracetamol may have very limited effectiveness in this subgroup of patients.…”

Section: Introductionmentioning

confidence: 99%

Neuropathic Pain in Hand Osteoarthritis: A Cross-Sectional Study

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Collier

McNair

et al. 2021

JCM

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Symptomatic hand osteoarthritis (OA) is a severely debilitating condition. Neuropathic pain (NP) has been shown to be a factor affecting pain severity, hand function, psychological wellbeing, body schema, and the number of pain medications in people with OA of other joints. The aim of this study was to assess the prevalence of NP in symptomatic hand OA and assess its association with pain, hand function, measures of psychological wellbeing, sleep, body schema disturbances, and number of pain medications. Participants with symptomatic hand OA diagnosed through the American College of Rheumatology criteria, were recruited and completed a series of online questionnaires. These included the Douleur Neuropathique 4 interview (DN4-interview), Short Form Brief Pain Inventory (SF-BPI), Neglect-like Symptoms questionnaire, Functional Index of Hand Osteoarthritis (FIHOA), Centre for Epidemiologic Studies Depression Scale (CES-D), Pain Catastrophising Scale (PCS), and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression with age, body mass index, and sex as covariates were utilised to assess differences between participants with and without NP as identified through the DN4-interview. Correlation analysis assessed the relationship between pain intensity, body schema alterations, and number of pain medications. A total of 121 participants were included in the present study. Forty-two percent of participants presented with NP. Participants with NP reported higher levels of worst pain (OR: 10.2 95%CI: 2.2 to 48.5; p = 0.007). Worst pain intensity correlated with the number of pain medications (rho = 0.2; p = 0.04), and neglect-like symptoms (rho = 0.4; p < 0.0001). No difference between phenotypes was shown for catastrophising, function, depression, neglect-like symptoms, pain interference, or sleep. A large proportion of people with symptomatic hand OA present with NP. This phenotype is characterised by greater levels of pain intensity. Pain intensity is associated with number of pain relief medications and body schema alteration. Psychological factors, hand function, and sleep do not appear to be affected by the presence of NP.

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Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes

Cited by 15 publications

References 39 publications

Personality Type and Chronic Pain: The Relationship between Personality Profile and Chronic Low Back Pain Using Eysenck’s Personality Inventory

Personality Type and Chronic Pain: The Relationship between Personality Profile and Chronic Low Back Pain Using Eysenck’s Personality Inventory

Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain

Neuropathic Pain in Hand Osteoarthritis: A Cross-Sectional Study

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