Relationships Among Pain Disability, Pain Intensity, Illness Intrusiveness, and Upper Extremity Disability in Patients With Traumatic Peripheral Nerve Injury

Novak, Christine B.; Anastakis, Dimitri J.; Beaton, Dorcas; Mackinnon, Susan E.; Katz, Joel

doi:10.1016/j.jhsa.2010.07.018

Cited by 65 publications

(35 citation statements)

References 40 publications

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“…Although medical advances continue to allow for improved mortality rates related to trauma, a proportion of patients may go on to develop pain beyond the acute phase, ie, develop persistent pain 6–11. The definition of persistent pain following traumatic musculoskeletal injury (TMsI) is not clearly defined in the literature; however, for the purposes of this review and consistent with Macrae and Davies’s definition of chronic postsurgical pain, persistent pain is defined as: (1) pain that develops after traumatic injury or after surgical intervention in the wake of traumatic injury; (2) pain that has been present for at least 2 months; (3) other causes of pain have been ruled out (eg, further surgical interventions have not occurred); and (4) the possibility that the pain is a continuation of a preexisting problem should be ruled out 12,13…”

Section: Introductionmentioning

confidence: 99%

Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

Rosenbloom¹,

Khan²,

McCartney³

et al. 2013

JPR

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138

116

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BackgroundPersistent pain and psychological distress are common after traumatic musculoskeletal injury (TMsI). Individuals sustaining a TMsI are often young, do not recover quickly, and place a large economic burden on society.ObjectivesThe aim of this systematic review is to determine (1) the incidence of persistent pain following TMsI, (2) the characteristics of pain, characterized by injury severity and type, and (3) risk and protective factors associated with persistent pain following TMsI.MethodsA systematic search of electronic databases (MEDLINE®, PubMed®, Embase, and PsycINFO®) was conducted for prospective, interventional, or noninterventional studies measuring the incidence of pain associated with TMsI.ResultsThe search revealed 4388 studies. Eleven studies examined persistent pain and met inclusion criteria. Pain was assessed using a validated measure of pain intensity or pain presence in six studies. Persistent pain was reported by all studies at variable time points up to 84 months postinjury, with wide variation among studies in pain intensity (ie, from mild to very severe) and pain incidence at each time point. The incidence of pain decreased over time within each study. Two studies found significant relationships between injury severity and persistent pain. Frequently cited predictive factors for persistent pain included: symptoms of anxiety and depression, patient perception that the injury was attributable to external sources (ie, they were not at fault), cognitive avoidance of distressing thoughts, alcohol consumption prior to trauma, lower educational status, being injured at work, eligibility for compensation, pain at initial assessment, and older age.Conclusion and implicationsThe evidence from the eleven studies included in this review indicates that persistent pain is prevalent up to 84 months following traumatic injury. Further research is needed to better evaluate persistent pain and other long-term posttraumatic outcomes.

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Section: Introductionmentioning

confidence: 99%

Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

Rosenbloom¹,

Khan²,

McCartney³

et al. 2013

JPR

Self Cite

138

116

View full text Add to dashboard Cite

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“…33 The evaluation of pain will always be a self-report by patients. Numerical Rating Scale (NRS) for pain and Pain Visual Analog Scale (PVAS) are used to determine pain intensity and are easy to use.…”

Section: Outcomes Assessmentmentioning

confidence: 99%

“…34 McGill Pain Questionnaire is a multidimensional pain scale which provides much more information on dimensions of pain beyond the simple factor of intensity, such as sensory components (tingling and hypersensitivity) as well as affective responses to pain. 33-36 However, it is a long questionnaire and imposes a larger burden on patients and might be less responsive than VAS. 34 The Pain Disability Index assesses the impact of pain on life domains.…”

Section: Outcomes Assessmentmentioning

confidence: 99%

“…34 The Pain Disability Index assesses the impact of pain on life domains. 33 It includes seven categories of life activity: family/ home responsibility, recreation, social activity, occupation, sexual behavior, self-care and life support activity. 37 Consistency, validity and reliability of this questionnaire were tested and proved to be useful in nerve injury studies.…”

Section: Outcomes Assessmentmentioning

confidence: 99%

“…37 Consistency, validity and reliability of this questionnaire were tested and proved to be useful in nerve injury studies. 33 In patients with chronic nerve injury, pain intensity is only one component of pain, and the impact of pain in the disability should also be considered. 33 A clear understanding of the goal of the research question will help determine which measurement is appropriate.…”

Section: Outcomes Assessmentmentioning

confidence: 99%

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How to Measure Outcomes of Peripheral Nerve Surgery

2013

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Synopsis Evaluation of outcomes after peripheral nerve surgeries include a number of assessment methods that reflect different aspects of recovery, including reinnervation, tactile gnosis, integrated sensory and motor function, pain and discomfort, neurophysiological and patient- reported outcomes. This review makes a list of measurements addressing these aspects as well as advantage and disadvantage of each tool. Because of complexities of neurophysiology, assessment remains a difficult process, which requires researchers focus on measurements best relevant to specific conditions and research questions.

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Advances in the repair of segmental nerve injuries and trends in reconstruction

2020

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Despite advances in surgery, the reconstruction of segmental nerve injuries continues to pose challenges. In this review, current neurobiology regarding regeneration across a nerve defect is discussed in detail. Recent findings include the complex roles of nonneuronal cells in nerve defect regeneration, such as the role of the innate immune system in angiogenesis and how Schwann cells migrate within the defect. Clinically, the repair of nerve defects is still best served by using nerve autografts with the exception of small, noncritical sensory nerve defects, which can be repaired using autograft alternatives, such as processed or acellular nerve allografts. Given current clinical limits for when alternatives can be used, advanced solutions to repair nerve defects demonstrated in animals are highlighted. These highlights include alternatives designed with novel topology and materials, delivery of drugs specifically known to accelerate axon growth, and greater attention to the role of the immune system. K E Y W O R D S acellular nerve allograft, autograft, nerve gap, nerve guidance conduit, peripheral nerve 2 | BIOLOGY OF NERVE REGENERATION ACROSS A DEFECT Peripheral nerve is capable of robust regeneration following injury. The molecular and cellular mechanisms have primarily been studied in rodent models. Following injury, neurons and their axons and the nonneuronal cellular environment distal to the injury undergo immediate morphological and molecular changes. Within the axon, there is a rapid influx of ions, principally calcium, as well as a disruption of transport proteins signaling a disruption to homeostasis with its end-organ. This multifactorial injury response from axon damage is rapidly transported to the neuron cell Abbreviations: ANA, acellular nerve allograft; ECM, extracellular matrix; FDA, Food and Drug Administration; FK506, tacrolimus; GDNF, glial cell line-derived neurotrophic factor; GFRα1, glial cell line-derived neurotrophic factor family receptor alpha-1; MRC, Medical Research

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Relationships Among Pain Disability, Pain Intensity, Illness Intrusiveness, and Upper Extremity Disability in Patients With Traumatic Peripheral Nerve Injury

Abstract: In patients with a peripheral nerve injury, a simple conceptualization assumes that pain disability is determined by pain intensity. This study evaluated the relationships among pain intensity, illness intrusiveness, and pain disability. Type a{ studyllev*l of evidenee Prognostic IV.

Cited by 65 publications

References 40 publications

Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

How to Measure Outcomes of Peripheral Nerve Surgery

Advances in the repair of segmental nerve injuries and trends in reconstruction

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