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Pain-related fear and avoidance are increasingly demonstrated to play an important role in adult and childhood chronic pain. The Fear of Pain Questionnaire for Children (FOPQC) is a 24-item measure of pain-related fear-avoidance in youth that has demonstrated good indices of reliability and validity, treatment responsiveness, and associations with brain circuitry alterations. This study describes the development and psychometric examination of the FOPQC-SF, a short form of the original measure. We selected 10 items for the short form that best represented the content and two-factor (Fear and Avoidance) structure of the original measure from a cohort of 613 youth (Mage = 14.7 years) with chronic pain. Next, confirmatory factor analyses from a second sample of 526 youth (Mage = 14.7 years) with chronic pain who completed the FOPQC-SF supported the original two-factor model but indicated that one item should be moved to the avoidance subscale. The FOPQC-SF demonstrates strong internal consistency and moderate-to-strong construct and criterion validity. Three-month test-retest reliability estimates (N=94) were strong and there was preliminary evidence of responsivity to change. To aid integration into intervention trials and clinical practice, we provide clinical reference points and a criterion to assess reliable change. The short form could be used for rapid identification of pain-related fear and avoidance in youth during clinic evaluations, and is optimized for clinical registries.
Learn More >Headache disorders are currently the sixth leading cause of disability across the globe and therefore carry a significant disease burden. This systematic review and meta-analysis aims to investigate the effects of yoga on headache disorders.
Learn More >Chronic pain is a multidimensional experience associated with psychosocial (e.g., pain-related beliefs and pain coping responses) and spiritual factors. Spirituality is a universal aspect of the human experience that has been hypothesized to impact pain experience via its effects on pain, physical/psychological function, resilience and pain-related beliefs, and pain coping responses. However, research evaluating the associations between measures of spirituality and measures of pain and function in individuals with chronic pain is limited. This study seeks to address this limitation.
Learn More >Previous studies suggest higher mindfulness may be associated with better sleep quality in people with chronic pain conditions. However, the relationship between mindfulness and sleep in fibromyalgia patients, who commonly suffer from sleep problems, remains unstudied. We examined the relationship between mindfulness and sleep, and how this relationship may be mediated by depression, anxiety, and pain interference in fibromyalgia patients.
Learn More >Because musculoskeletal pain problems are so prevalent, new methods of evaluating and treating patients are needed to increase effectiveness. Subgrouping is a method where patients are classified into defined groups based on psychosocial factors with the expectation of more specific and tailored treatments for them. For those seeking care for a new episode, the risk of developing chronic pain-related disability is assessed, while for those with existing pain the risk for the maintenance of the chronic pain problem is evaluated. In this narrative review we examine the subgrouping of patients with regard to methods of evaluation as well as to whether subgrouping actually facilitates treatment. For the development of disability, screening tools e.g. the Örebro Musculoskeletal Pain Screening Questionnaire accurately stratify patients into group (e.g. high, medium, low risk) that predict future pain-related work disability. In addition, several studies show that treatments that directly key on risk groups enjoy enhanced outcomes compared to treatment as usual. For the maintenance of chronic musculoskeletal pain problems there are several instruments that classify patients into specific groups or profiles e.g. based on the avoidance and endurance model or the ICF assessment. While some evidence shows that these classifications are related to treatment outcome, we found no study that directly tested a system for providing treatment matched to the subgrouping for maintenance. We conclude that it is possible to reliably subgroup patients with musculoskeletal problems. Likewise, treatments that address the risk factors in the screening procedure, may enhance outcomes compared to treatment as usual. More work is needed however, to better understand mechanism so assessment methods can be improved and treatment specific to subgroups can be developed.
Learn More >Despite rising morbidity and mortality from the opioid epidemic and other addictions, people who inject drugs (PWID) remain understudied regarding pain outcomes. Data among PWID regarding chronic pain and drug use, including non-medical use of opioids, is largely unknown. We examined the prevalence of chronic pain and drug use for pain in this population.
Learn More >To investigate a proposed cognitively-mediated pathway whereby pain contributes to gait impairments by acting as a distractor in community-living older adults.
Learn More >Pain is a complex and highly subjective phenomenon that can be modulated by several factors. Based on results from experimental and clinical studies, the existence of endogenous pain modulatory mechanisms that can increase or diminish the experience of pain is now accepted. In this narrative review, the pain modulatory effects of exercise, stress, and cognitions in humans are assessed. Experimental studies on the effect of exercise have revealed that pain-free subjects show a hypoalgesic response after exercise. However, in some patients with chronic pain this response is reduced or even hyperalgesic in nature. These findings will be discussed from a mechanistic point of view. Stress is another modulator of the pain experience. Although acute stress may induce hypoalgesia, ongoing clinical stress has detrimental effects on pain in many patients with chronic pain conditions, which have implications for the understanding, assessment and treatment of stress in patients with pain. Finally, cognitive strategies play differing roles in pain inhibition. Two intuitive strategies, thought suppression and focused distraction, will be reviewed regarding experimental, acute, and chronic pain. Based on current knowledge on the role of exercise, stress, and cognitive pain control strategies on modulation of pain, implications for treatment will be discussed.
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