APS Press Room
News Highlights from The Journal of Pain • May 2007
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
New Study Links Obesity with Higher Incidence of Chronic Pain
Obese adults are more likely to experience chronic pain than normal weight or underweight individuals, according to a study published in The Journal of Pain.
Researchers working on the Southern Pain Prevalence Study analyzed the relation between body-mass index (BMI) and moderate to severe pain. Further, data collected for the study confirmed that obesity is a major health problem in the southeast, citing nearly 40 percent of the surveyed population is overweight and 30 percent considered obese.
Results in 3,637 study participants showed that as BMI increases, so does the likelihood of self-reported pain. Those with body mass index ratings from 30 to 34.9 were 1.8 times as likely to report severe pain vs. normal or underweight individuals. This rose to 2.3 times among the severely obese with BMIs above 40.
The study noted that pain wasn’t restricted to weight-bearing joints. At higher levels of obesity, respondents were more likely to experience pain in a variety of locations.
As the obesity epidemic grows, so will the incidence of persistent pain, now estimated to affect some 50 million Americans. The study concluded that if the relationship between obesity and pain is reciprocal, obesity interventions could become a pain management strategy and effective pain management could help increase physical activity and prevent further weight gain.
Source: Comorbidity of Obesity and Pain in a General Population: Results from the Southern Pain Prevalence Study, Holli C. Hitt, University of Alabama Birmingham; Robert C. McMillen, Tonya Thornton-Neaves and Arthur G. Crosby, Mississippi State University; and Karen Koch, North Mississippi Medical Center.
Study Shows Reporting Biases in Pain Assessments
How your pain is assessed might depend on who is on the other end of the conversation, according to a study in The Journal of Pain, the peer-review publication of the American Pain Society.
Researchers from the University of Michigan observed pain and mood in 70 patients with low-back pain. At their two-week follow-up, they were asked to recall their postprocedural rating at the time they received epidural lumbar injections. Since there are no biomarkers for pain, subjective patient reports are used extensively in pain intensity evaluations. In this study, patients who were called by physicians gave pain ratings that closely matched the post-procedural ratings. However, those phoned by research assistants gave significantly worse pain ratings, showing a clear assessor bias in the pain ratings.
From a clinical perspective, the researchers noted that physicians depend on patient pain recall to assess trends and progression of therapy. From the study, it cannot be concluded that physicians or research assistant give inaccurate pain assessments. However, intensity ratings do differ based on the status of the reviewers. It was recommended that serial pain assessments should be by done individuals of similar status over time to minimize reporting biases.
Source: Assessor Status Influences Pain Recall, David A. Williams, Karen M. Park, Kristen R. Ambrose and Daniel J. Clauw, University of Michigan
Does Chronic Pain Affect Adolescent Self Perception?
The goal of this study, conducted by researchers at Children’s Hospital in Boston and Children’s Hospital in Philadelphia, was to examine the level of self-perceived competence in school among adolescents with musculoskeletal pain syndromes. They performed a retrospective review of 115 adolescents. Though self-perceived competence among adolescents with chronic pain conditions has not been studies extensively, existing research shows that chronic pain is associated with poorer perceived competence.
Results showed that pain intensity was less predictive of functional disabilities among adolescents with low global self worth perception, defined as the extent to which the adolescents like themselves. The authors concluded that when global self worth is low among youth with chronic pain, factors other than pain may play a role in determining functional impairment. Among adolescents with high self worth, functional outcomes are more closely linked with pain severity.
Source: Adolescent Self-Perception: Associations with Chronic Musculoskeletal Pain and Functional Disability, Jessica W. Guite, David D. Sherry and John B. Rose, The Children’s Hospital of Philadelphia; and Deirdre E. Logan, Children’s Hospital of Boston
Suppressed Emotions Foster Increased Pain Anger in Low-Back Pain Patients
Researchers from Duke University Medical Center sought to determine if individuals with chronic low back pain who demonstrate ambivalence over emotional expression (AEE) would report higher levels of pain and higher levels of anger about their pain. AEE is defined as the tendency to be conflicted about expressing emotions.
Sixty-one low-back pain patients were studied and completed an AEE questionnaire. Their pain was assessed using the McGill Pain Questionnaire. Results showed that AEE is meaningfully related to pain and anger scores in those with persistent low-back pain.
Further, this is the first study to demonstrate a link between AEE and anger about pain. The researchers concluded that their findings emphasize the need to recognize that anger management can be helpful to emotionally suppressed patients in coping with persistent pain.
Source: Conflict About Expressing Emotions and Chronic Low Back Pain: Associations with Pain and Anger, James W. Carson, Francis J. Keefe, Kathryn P. Lowry, Laura S. Porter Veerainder Goli and Ann Marie Fras, Duke University Medical Center