Mindful Self-Compassion to Reduce Pain Interference Among Adults with Osteogenesis Imperfecta.

Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals. Measures of pain intensity and interference, physical and psychological functioning, coping responses, self-efficacy, and satisfaction with social support were administered to a sample of 324 Portuguese patients with chronic musculoskeletal pain. Univariate and multivariate analyses were computed. Findings were interpreted with respect to those from similar studies using English-speaking individuals. Coping responses and perceived social support were significantly associated with pain interference and both physical and psychological functioning; self-efficacy beliefs were significantly associated with all criterion variables. All coping responses, except for task persistence, were positively associated with pain interference and negatively associated with physical and psychological functioning, with the strongest associations found for catastrophizing, praying/hoping, guarding, resting, asking for assistance, and relaxation. The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.

Secular Mindfulness-Based Interventions: Efficacy and Neurobiology.

Individuals with chronic pain commonly report significant functional impairment and reduced quality of life. Despite this, little is known about psychological processes and mechanisms underpinning enhancements in well-being within this population. The study aimed to investigate whether (1) increased levels of pain intensity and interference were associated with lower levels of mental well-being, (2) increased positive goal engagement was associated with higher levels of mental well-being and (3) whether the relationships between pain characteristics and mental well-being were mediated by increased positive goal engagement. A total of 586 individuals with chronic pain participated in the cross-sectional, online study. Participants completed self-report measures to assess pain intensity and interference, mental well-being and goal motivation variables. Results showed that pain interference and positive goal engagement were associated with mental well-being. Moreover, the relationship between pain interference and mental well-being was partially mediated by positive goal engagement. The results provide tentative evidence for the protective role of positive goal engagement in enabling individuals with chronic pain to maintain a sense of mental well-being. The study develops the biopsychosocial model of chronic pain by examining the roles and relationships of relevant yet previously unexplored psychological constructs. The promotion of mental well-being through the enhancement of positive goal engagement is discussed, offering a platform for further research and clinical interventions.

Examining Pain Subgroups One and Five Years After Spinal Cord Injury: The Importance of Depression in Chronic Pain.

BackgroundChronic pain may affect and interfere in children’s everyday life and can be present in children with Osteogenesis Imperfecta (OI). However, the knowledge is still sparse to what extent pain is present, how pain interfere in children’s everyday life and affect their self-perceived health status. The purpose of the study was therefore to explore presence of chronic pain, pain interference in daily life, and self-perceived health status in children with OI.MethodsChildren with OI, aged 6–18 years, were recruited consecutively to this cross-sectional study. Participants answered a standardised interview including five pre-structured questions, and the Numeric Pain Rating Scale (NPRS), the Pain Interference Index, and a questionnaire concerning self-perceived health status the Patient Reported Outcomes Measurement Information System Pediatric-25 Profile v1.1 (PROMIS-25).ResultsTwenty-eight children (median: 11 years, IQR 6) with OI type I, III, or IV participated. Pain was present in 27 of 28 children and interfered in their everyday life regardless of OI-type, sex, and age. The median NPRS for average pain intensity was 4 (IQR 2), the median for pain frequency was 2–3 times/week, and the median frequency of school absence due to pain was 2–3 times per month. The most common pain locations were back and feet. Pain in the feet was more frequently reported in children with type I (p = 0.032), and pain in the hip was more often reported in children ≥13 years (p = 0.011). The children were asked what they thought to be the cause of pain and the most frequent response was “walking long distances”. Self-perceived health status for mobility was lower than the general population, and lowest for children with type III (p = 0.016). Pain interference was associated with children’s self-perceived health status (rs = 0.84, p < 0.001).ConclusionAlmost all children experienced pain, which interfered in children’s everyday lives, affected participation in various activities and was associated with reduced self-perceived health status. If children avoid physical activities because of pain, it might cause a vicious circle of inactivity, which further decreases bone density and increase the risk of fractures. The results emphasize the importance to offer adequate pain reducing interventions.

Chronic pain occurs in 30% of older adults. This prevalence rate is expected to increase, given the growth in the older adult population and the associated growth of chronic conditions contributing to pain. No population-based studies have provided detailed, longitudinal information on the experience of chronic pain in older adults; the pharmacological and nonpharmacological strategies that older adults use to manage their chronic pain; and the effect of chronic pain on patient-reported outcomes. This article aims to describe the protocol for a population-based, longitudinal study focused on understanding the experience of chronic pain in older adults. The objectives are to determine the prevalence and characteristics of chronic pain; identify the pharmacological and nonpharmacological pain treatments used; evaluate for longitudinal differences in biopsychosocial factors; and examine how pain types and pain trajectories affect important patient-reported outcomes. Also included are the results of a pilot study. A population-based sample of approximately 1,888 older adults will be recruited from the National Opinion Research Center at the University of Chicago's AmeriSpeak Panel to complete surveys at three waves: enrollment (Wave 1), 6 months (Wave 2), and 12 months (Wave 3). To determine the feasibility, a pilot test of the enrollment survey was conducted among 123 older adults. In the pilot study, older adults with chronic pain reported a range of pain conditions, with osteoarthritis being the most common. Participants reported an array of pharmacological and nonpharmacological pain strategies. Compared to participants without chronic pain, those with chronic pain reported lower physical and cognitive function and poorer quality of life. Data collection for the primary, longitudinal study is ongoing. This project will be the first longitudinal population-based study to examine the experience and overall effect of chronic pain in older adults. Pilot study results provide evidence of the feasibility of study methods. Ultimately, this work will inform the development of tailored interventions for older patients targeted to decrease pain and improve function and quality of life.

Chronic refractory pain presents limited treatment options and diminished quality of life. While ketamine treatment shows promise, protocol variations and safety concerns have hindered widespread adoption. This study evaluated preliminary effectiveness and rate of treatment completion for a standardized low-dose ketamine infusion therapy (KIT) protocol. This retrospective observational study examined adult patients with chronic refractory pain who received KIT between May 2021 and October 2024 at the Cleveland Clinic's outpatient multidisciplinary pain clinic. Patients received a standardized protocol of 0.5 mg/kg ketamine infused over 40 min for five consecutive days. We measured effectiveness using patient-reported outcomes (PROs) at baseline, last infusion, and 3-month and 6-month post-treatment, and rate of treatment completion. The primary outcome of interest was the proportion of patients achieving clinically meaningful improvement on validated measures. Among 1034 patients (mean age 50.4±15.2 years; 71.8% female; 83.3% of white ethnicity), treatment completion was high, with 890 (86.1%) patients completing 5+ infusions. No adverse events were reported. Baseline measures reflected moderate impairment in pain interference, global physical health, fatigue, physical function, and depression. Between 20.3% and 46.4% of patients achieved clinically meaningful improvement on PROs from baseline to last infusion, with similar proportions maintained at 3-month and 6-month follow-up. Statistically significant mean improvements were observed across multiple domains; however, the majority of individual outcomes did not reach clinically meaningful thresholds. Patients demonstrated significant mean improvements in fatigue, pain interference, and social role satisfaction (mean change -2.1±7.7, -2.0±5.8, and 2.0±7.7, respectively), with improvements in depression, social role satisfaction, pain interference, self-efficacy, global health, and pain catastrophizing sustained through 6 months post-treatment. This standardized low-dose ketamine protocol demonstrated therapeutic benefit and high completion rates within a multidisciplinary care model. Future randomized controlled trials are warranted to confirm findings and explore treatment response factors across pain conditions.

Response to a mindful self-compassion intervention in teens: A within-person association of mindfulness, self-compassion, and emotional well-being outcomes

Older adults are especially susceptible to chronic musculoskeletal (MSK) pain. Pharmacological treatment often provides inadequate relief and overuse can lead to adverse events. Preliminary research has demonstrated the effectiveness of virtual reality (VR) distraction therapy for chronic pain. Understanding attitudes of older adults towards VR distraction therapy will help develop and optimize this therapy for this population. Therefore, the purpose of this study is to explore the attitudes and treatment acceptability towards the use of immersive VR distraction therapy of older adults suffering from chronic MSK pain. This descriptive, exploratory study used mixed methods. Data collection consisted of a consent process, eligibility screening, survey completion, 2 VR simulations (passive and active) lasting 10-minutes each, and either a focus group or interview. Survey data was used to measure: pain intensity and interference, pain catastrophizing, treatment acceptability, usability, and side effects. A total of 21 older adults completed the study. Treatment acceptability was high with an average score of 32.5 out of 40. However, average usability scores (62.9 out of 100) indicated a need for system improvements. Few participants (14%) experienced moderate to severe side effects. The following themes were identified: 1) VR is an enjoyable distraction; 2) Perceived effectiveness depends on chronic pain experience; 3) VR simulation experiences should be individualized; 4) Design considerations to improve usability in older adults; 5) Recommendations for future directions. The findings from this study can inform intervention design considerations and future directions for the use of VR technology for chronic pain management in older adults.

One in five Americans adults report experiencing chronic pain and stated it has negatively impacted their lives by limiting their engagement in activities. The magnitude of pain experienced is more severe in older adults, which may be due to age-related differences in pain perception pathways leaving older adults more vulnerable to the negative impact of pain. The most common type of chronic pain experienced by older adults involves musculoskeletal disorders, which is consistent with age-related declines muscle strength and mass. Declines in handgrip strength is associated with chronic pain perception and poor cognitive functioning. Older adults who experience severe chronic pain have worse working memory and attention. The experience of chronic pain is attentionally demanding on cognitive processes making it difficult for older adults to draw their attention away from pain perception during cognitively demanding tasks. Chronic pain is also associated with accelerated decline in cognition, dementia, and Alzheimer’s Disease pathogenesis. As a GSA policy intern, I represented GSA in the Protecting Access to Pain Relief Coalition to explore policy initiatives and recommendations in relation to chronic pain experienced by older adults. Research on chronic pains’ impact on cognitive and physical function is often conducted in isolation. However, they seldom occur in isolation during real-world tasks. Therefore, research on tasks that involve simultaneous physical and cognitive functioning in relation to chronic pain is imperative. In addition, handgrip strength should be considered as a useful cost-effective screening tool as a measure for cognitive decline in older adults with chronic pain.

ObjectiveIndividuals with chronic pain are uniquely challenged by the COVID-19 pandemic, as increased stress may exacerbate chronic pain, and there are new barriers to receiving chronic pain treatment. In light of this, using a large online sample in the United States, we examined 1) the early impact of COVID-19 on pain severity, pain interference, and chronic pain management; and 2) variables associated with perceived changes in pain severity and pain interference.DesignA cross-sectional study.MethodsOnline survey data for 1,453 adults with chronic pain were collected via Amazon’s Mechanical Turk platform.ResultsAlthough a large proportion of participants reported no perceived changes in their pain severity and pain interference since the outbreak, approximately 25–30% of individuals reported exacerbation in these domains. Individuals identifying as Black and of non-Hispanic origin, who experienced greater disruptions in their mood and sleep quality, were more likely to report worsened pain interference. The majority of participants reported engaging in self-management strategies as usual. However, most appointments for chronic pain treatment were either postponed or canceled, with no future session scheduled. Furthermore, a notable proportion of participants had concerns about or difficulty accessing prescription opioids due to COVID-19.ConclusionsWe may expect to see a long-term exacerbation of chronic pain and related interference in functioning and chronic pain management among individuals most impacted by the pandemic. These individuals may benefit from remotely delivered intervention to effectively mitigate COVID-19–related exacerbations in chronic pain and interruptions in face-to-face treatment.

Introduction In 2021, almost 52 million adults in the U.S. reporting having chronic pain, 17 million of whom also reported that their pain significantly interfered with their daily lives. While poor sleep is recognized as a risk factor for chronic pain and vice versa, less is known about the temporal relationship between characteristics of pain (such as interference and location) and multiple dimensions of sleep health. Methods The current study investigated longitudinal bidirectional relationships between aspects of chronic pain and a multidimensional measure of sleep health incorporating sleep regularity, satisfaction, alertness, timing, efficiency, and duration in three ways: presence of chronic pain, interference of pain with daily life (such as activities and social relationships), and number of pain locations. The components of the sleep health composite score were measured using a combination of Actigraphy and self-report from a daily sleep diary over 7 consecutive days. The analytical sample consisted of 154 middle-age and older adults from the Midlife in the United States (MIDUS) longitudinal study who responded to questions about chronic pain and provided Actigraphy and sleep diary data. Results Bidirectional associations between pain interference and sleep health were found in a subsample of participants (N = 107) who responded to questions about how much their pain interfered with their daily life. These associations indicate that an increase in sleep health problems from timepoint 1 (T1) to timepoint 2 (T2) approximately 9 years later was associated with an increase in pain interference (B =.31, SE =.14, p =.03), and that an increase in pain interference from T1 to T2 was associated with more sleep problems at T2 (B =.16, SE =.07, p =.03) even after controlling for sociodemographic and health covariates as well as baseline sleep health and baseline pain interference. Conclusion These findings may have implications for behavioral changes that can be made to reduce pain interference and can provide a foundation for investigating possible mechanisms of the relationship between sleep and pain such as inflammation. Support (if any) This study was supported by NIH grant (R01HL163226, PI Lee.)

Background and Aims: The Global Burden of Disease Study 2016 confirmed that the high prevalence of pain and pain-related diseases is the leading cause of disability and disease burden globally. Pain is the most common reason patients consult primary care providers in the United States. According to recent literature, over 40% of adult Americans, an estimated 100 million people, live with chronic or recurrent pain. Of these, approximately 11 million adults in the US have high-impact chronic pain, or pain that lasts 3 months or longer and is accompanied by at least one major activity restriction. Ongoing research is needed to identify alternative strategies to existing treatment approaches as a means to reduce pain severity, pain interference with function, and to improve patients’ overall quality of life. Optimal treatment strategies employ multimodal approaches that provide optimal benefit and minimal harm. Chronic pain is often categorized as either nociceptive (caused by damage to tissue or inflammatory stimuli) or neuropathic (damage to somatosensory nervous system). Mainstay therapies for pain include anti-inflammatory agents, opioids, and other oral and topical analgesics. Despite this approach, a large percentage of pain patients do not achieve adequate pain relief, and these traditional medication approaches are often associated with undesirable and potentially dangerous adverse effects. Alternative evidence-based multimodal approaches of pain management are therefore needed. Potential therapies include use of combination pharmacotherapies, which target both central and peripheral nociceptive mechanisms, and nonpharmacological interventions. Incorporation of micro and nanotechnologies into the development of novel treatment formulations has shown to have positive effects on patients. Topical analgesics, including pain relief patches, are a potentially valuable strategy in the management of a variety of conditions associated with musculoskeletal and various neuropathic pain disorders. The purpose of this minimal risk, observational study was to evaluate patients with mild or moderate pain and evaluate perceptions of pain treatment and associated symptoms with the use of a novel, non-drug and micro/nanotechnology-based topical pain-relieving patch via validated scales over the course of 30 days. Methods: This analysis of the PREVENT IRB-approved study evaluated the efficacy of a topical pain-relieving patch (Kailo Pain Relieving Patch (Pain Relief Technologies, USA) in reducing Brief Pain Inventory (BPI) scores in patients experiencing mild, moderate, or severe pain. The Treatment Group (TG) of 128 adult patients (89 females,39 males) with arthritic, neuropathic, or musculoskeletal pain received patches for 30 days. A Control Group (CG) of 20 adult patients (15 females, 5 males) did not initially receive the patch, and then crossed over to the Crossover Treatment Group (CROSSG), Surveys were administered to all patients at baseline, 14 days, and 30 days to assess changes in pain severity and interference by BPI Short Form. Changes in oral pain medication use, side effects and satisfaction with patch use were also assessed. Results: Over 30 days, treatment group mean BPI Severity score decreased 61% (4.9 to 1.9/10?P&lt; .001) and mean BPI Interference score decreased 61% (3.8 to 1.5/10?P&lt; .001) The control group showed an increase in both BPI Severity of 23% (3.0 to 3.7/10) and BPI Interference Score of 58% (1.2 to 1.9/10). After crossing over to treatment, patients in the crossover group reported a decrease in BPI Severity score of 76% (3.7 to .9/10) and a decrease in BPI Interference score of 79% (1.9 to .4/10). No side effects of treatment were reported. After 30 days, 91% of patients reported “less” or “a lot less” usage of oral medications. 86% of patients were very/extremely satisfied with the patch and preferred the pain-relieving patch to oral medications. Results also showed improvements in Quality of Life (QoL), mood, and relations with other people, sleep, walking ability, and enjoyment of life. Conclusions: Study results indicate that this novel, micro/nanotechnology-based topical pain-relieving patch can reduce BPI pain severity and interference scores and related pain for adult patients with arthritic, neuropathic, and musculoskeletal pain. Options such as this should be considered by healthcare clinicians and patients as part of a multimodal treatment approach. Patient outcomes further encourage more research to be conducted to confirm these results.

Integrated Behavioral Treatment for Veterans With Co-Morbid Chronic Pain and Hazardous Opioid Use: A Randomized Controlled Pilot Trial

Data are equivocal on the consequences of COVID-19 pandemic on pain and well-being for individuals with chronic pain. Furthermore, little is known regarding its impact on the health of young adults with chronic pain. We conducted a longitudinal study to compare pain, psychological functioning, and substance use before and during the pandemic of 196 young adults with chronic pain. Participants aged 18 to 24 years (M = 21.1 years; 79.6% females) reported on pain, anxiety, depression, and substance use before (October 2018-August 2019) and during the pandemic (October 2020-November 2020), in addition to the assessment of COVID-19 exposure and its impact. Before the pandemic, young adults experienced mild-to-moderate pain intensity (M = 3.75, SD = 2.33) and pain interference (M = 3.44, SD = 2.69). Findings were that pain intensity, pain interference, and depression symptoms remained stable during the pandemic. In contrast, anxiety symptoms increased significantly (M = 8.21, SD = 5.84 vs M = 8.89, SD = 5.95, P = 0.04). Tobacco, alcohol, and cannabis use were unchanged. Mixed linear models revealed that COVID-19 exposure and impact were not associated with changes in pain intensity or interference, with female sex associated with increased pain intensity (β = 0.86, P = 0.02) and pain interference (β = 0.87, P = 0.02). Our findings indicated relative stability of pain symptoms experienced by young adults with chronic pain. However, the increases in anxiety highlight the need to facilitate treatment access for mental health services to mitigate downstream impact.