• Central sensitization
• Modified Harris Hip Score
• Neuropathic pain
• Total hip arthroplasty
• Western Ontario and McMaster Universities Osteoarthritis Index

• Humans
• Catastrophization/psychology
• Pain/psychology
• Pain/physiopathology
• Stress, Psychological/psychology
• Stress, Psychological/physiopathology
• Thinking/physiology

• K24 AR081143 NIAMS NIH HHS
• K24 NS126570 NINDS NIH HHS
• R01 AT012144 NCCIH NIH HHS
• R01 NS121419 NINDS NIH HHS

• cost-effectiveness
• nab-paclitaxel
• overall survival
• pancreatic cancer
• second line

• Catastrophization
• Depression
• Musculoskeletal diseases
• Pain
• Review

• Humans
• Rheumatic Diseases/psychology
• Rheumatic Diseases/epidemiology
• Rheumatic Diseases/complications
• Prevalence
• Catastrophization/psychology

• 0026/2019-00 Narodowe Centrum Badań i Rozwoju

• central sensitization
• complex regional pain syndrome
• quantitative sensory testing
• spatial pain extent
• temporal summation of pain

• Humans
• Cross-Sectional Studies
• Pain Measurement
• Central Nervous System Sensitization
• Pain
• Complex Regional Pain Syndromes/diagnosis

• Clinical Research Priority Program (CRPP) Pain of the University of Zurich

• Temporomandibular disorders
• diagnostic criteria for temporomandibular disorders
• facial pain
• orofacial pain
• pain drawing

• Humans
• Female
• Adult
• Cross-Sectional Studies
• Facial Pain
• Neck Pain/diagnostic imaging
• Temporomandibular Joint Disorders/complications
• Temporomandibular Joint Disorders/diagnostic imaging
• Masseter Muscle

• Chronic Pain
• Neurological injury
• Neurological pain
• Neurology
• Rehabilitation medicine
• Rheumatology

• Humans
• Cohort Studies
• Longitudinal Studies
• Prognosis
• Prospective Studies
• Quality of Life
• Sciatica/diagnosis
• Low Back Pain

• MR/W027003/1 Medical Research Council
• MR/W002388/1 Medical Research Council
• Wellcome Trust
• 19/0005984 Diabetes UK
• Department of Health
• Sir Charles Gairdner Hospital and Osborne Park Health Care Group Research Advisory Committee Grant
• NIHR Oxford Health Biomedical Research Centre
• Arthritis Australia
• Charlies foundation for Research
• NIHR Biomedical Research Centre South London and Maudsley NHS Foundation Trust
• Raine Medical Research Foundation
• Dorothy Hodgkin Career Development Fellowship
• UKRI and Versus Arthritis as part of the UKRI Strategic Priorities Fund (SPF) Advanced Pain Discovery Platform (APDP)

• central sensitization
• inflammatory cytokines
• nerve growth factor
• osteoarthritis
• pain
• peripheral sensitization

• MRI
• cervical radiculopathy
• clinical agreement study
• pain distribution
• pain drawing

Chronic pain due to osteoarthritis (OA) is a prevalent cause of global disability. New biomarkers are needed to improve treatment allocation, and genetic polymorphisms are promising candidates.

We aimed to assess the association of OPRM1 (A118G and C17T) and brain-derived neurotrophic factor (BDNF [G196A]) polymorphisms with pain-related outcomes and motor cortex excitability metrics (measured by transcranial magnetic stimulation) in 113 knee OA patients with chronic pain. We performed adjusted multivariate regression analyses to compare carriers versus non-carriers in terms of clinical and neurophysiological characteristics at baseline, and treatment response (pain reduction and increased cortical inhibitory tonus) after rehabilitation.

Compared to non-carriers, participants with polymorphisms on both OPRM1 (A118G) and BDNF (G196A) genes were less likely to improve pain after rehabilitation (85 and 72% fewer odds of improvement, respectively). Likewise, both carriers of OPRM1 polymorphisms (A118G and C17T) were also less likely to improve cortical inhibition (short intracortical inhibition [SICI], and intracortical facilitation [ICF], respectively). While pain and cortical inhibition improvement did not correlate in the total sample, the presence of OPRM1 (A118G) and BDNF (G196A) polymorphisms moderated this relationship.

These results underscore the promising role of combining genetic and neurophysiological markers to endotype the treatment response in this population.

• central nervous system
• cytokines
• low-grade inflammation
• neuropsychiatric disease
• osteoarthritis
• signaling

• Hip pain
• Joint disease
• Physiotherapy
• Training

• Adult
• Arthralgia
• Feasibility Studies
• Hip Dislocation
• Humans
• Pain
• Patient Education as Topic

• Hip
• Musculoskeletal disorders
• REHABILITATION MEDICINE
• SPORTS MEDICINE

• Exercise
• Follow-Up Studies
• Hip Dislocation
• Hip Dislocation, Congenital
• Humans
• Middle Aged
• Pain
• Patient Education as Topic
• Quality of Life
• Randomized Controlled Trials as Topic

• Danish Health Fund
• Aase and Ejnar Danielsen's Foundation, the Research Foundation of the Association of Danish Physiotherapists
• Research Foundation of the Association of Danish Physiotherapists
• TrygFonden
• Fogh-Nielsen Legacy, Aarhus University
• A.P. Moller Foundation
• Danish Rheumatism Association

We investigated the differences in outcomes after total hip arthroplasty (THA) for hip osteoarthritis (HOA) between patients with and without central sensitivity syndromes (CSSs) other than fibromyalgia (FM). After excluding two patients with FM, we compared the clinical data of 41 patients with CSSs and 132 patients without CSSs. Clinical data included scores on the central sensitization inventory, visual analog scale for pain (VAS pain), and Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ). VAS pain was significantly higher at 3 and 6 months after THA in patients with CSSs than in those without CSSs (3 and 6 months, P < 0.001). Satisfaction, pain, and mental JHEQ scores were lower in patients with CSSs than in those without CSSs (satisfaction, P < 0.001; pain, P = 0.011; mental, P = 0.032). Multiple regression analyses indicated that one and ≥ 2 CSS diagnoses significantly impacted the satisfaction score (one CSS, β = − 0.181, P = 0.019; ≥ 2 CSSs, β = − 0.175, P = 0.023). Two or more CSSs were the only factor influencing the pain score (β = − 0.175, P = 0.027). Pain in patients with CSSs reflects central sensitization, which may adversely affect post-operative outcomes. Surgeons should pay attention to patients with a history of CSSs diagnoses who undergo THA for HOA.

To evaluate whether digital pain extent is associated with an array of psychological factors such as optimism, pessimism, expectations of recovery, pain acceptance, and pain self-efficacy beliefs as well as to analyse the association between digital pain extent and pain intensity and pain-related disability in people with chronic musculoskeletal pain.

A descriptive cross-sectional study conducted in a primary health care setting was carried out including 186 individuals with chronic musculoskeletal pain. Patient-reported outcomes were used to assess psychological factors, pain intensity, and pain-related disability. Digital pain extent was obtained from pain drawings shaded using a tablet and analysed using novel customized software. Multiple linear regression models were conducted to evaluate the association between digital pain extent and the aforementioned variables.

Digital pain extent was statistically significantly associated with pain intensity. However, digital pain extent was not associated with any psychological measure nor with pain-related disability.

The results did not support an association between digital pain extent and psychological measures.

• Chronic pain
• Cognition
• Cross-sectional
• Digital pain extent
• Musculoskeletal pain
• Pain drawing

• neurology
• chronic pain
• rehabilitation
• biomarkers

• Aged
• Aged, 80 and over
• Arthralgia/diagnosis
• Arthralgia/etiology
• Arthralgia/physiopathology
• Beta Rhythm/physiology
• Brain/physiopathology
• Cross-Sectional Studies
• Female
• Humans
• Male
• Middle Aged
• Osteoarthritis, Knee/complications
• Osteoarthritis, Knee/diagnosis
• Pain Measurement
• Prospective Studies
• Rest/physiology
• Severity of Illness Index
• Theta Rhythm/physiology

• 2017/12943-8 Fundação de Amparo à Pesquisa do Estado de São Paulo

• frozen shoulder
• pain drawings
• pain extent
• pain location
• pain sensitization
• psychological factors

This study aims to investigate the associative and multivariate relationship between different sociodemographic and clinical variables with cortical excitability as indexed by transcranial magnetic stimulation (TMS) markers in subjects with chronic pain caused by knee osteoarthritis (OA). This was a cross-sectional study. Sociodemographic and clinical data were extracted from 107 knee OA subjects. To identify associated factors, we performed independent univariate and multivariate regression models per TMS markers: motor threshold (MT), motor evoked potential (MEP), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). In our multivariate models, the two markers of intracortical inhibition, SICI and CSP, had a similar signature. SICI was associated with age (β: 0.01), WOMAC pain (β: 0.023), OA severity (as indexed by Kellgren–Lawrence Classification) (β: − 0.07), and anxiety (β: − 0.015). Similarly, CSP was associated with age (β: − 0.929), OA severity (β: 6.755), and cognition (as indexed by the Montreal Cognitive Assessment) (β: − 2.106). ICF and MT showed distinct signatures from SICI and CSP. ICF was associated with pain measured through the Visual Analogue Scale (β: − 0.094) and WOMAC (β: 0.062), and anxiety (β: − 0.039). Likewise, MT was associated with WOMAC (β: 1.029) and VAS (β: − 2.003) pain scales, anxiety (β: − 0.813), and age (β: − 0.306). These associations showed the fundamental role of intracortical inhibition as a marker of adaptation to chronic pain. Subjects with higher intracortical inhibition (likely subjects with more compensation) are younger, have greater cartilage degeneration (as seen by radiographic severity), and have less pain in WOMAC scale. While it does seem that ICF and MT may indicate a more acute marker of adaptation, such as that higher ICF and MT in the motor cortex is associated with lesser pain and anxiety.

• Neuropathic pain
• Osteoarthrits
• Phenotyping
• Sensitization

• Colored Drawings
• Neuropathic Pain
• Pain Distribution
• Pain Qualities
• Reliability

• spinal cord diseases
• neuropathic pain

• Adult
• Cross-Sectional Studies
• Humans
• Neuralgia/diagnosis
• Neuralgia/etiology
• Pain Measurement
• Reproducibility of Results
• Spinal Cord
• Spinal Cord Injuries/complications

• Swiss Spinal Cord Injury Cohort Study (2016-N-005)

• clinical assessment
• diagnosis
• evaluation
• oro-facial pain
• pain drawing
• temporomandibular disorders

• cervical
• chronic pain
• pain drawing
• radiculopathy
• widespread pain

• Adaptation, Psychological
• Adult
• Age Factors
• Aged
• Cervical Vertebrae
• Depression/etiology
• Disability Evaluation
• Disabled Persons
• Exercise
• Female
• Health Status
• Humans
• Male
• Middle Aged
• Pain/etiology
• Pain/psychology
• Pain Measurement
• Quality of Life
• Radiculopathy/complications
• Self Efficacy
• Sex Factors
• Socioeconomic Factors
• Sweden
• Work Capacity Evaluation
• Young Adult

This study deals with how pain characteristics in conjunction with other factors affect quality of life (QoL) in a vulnerable primary care population. We recruited vulnerable older people (75+, n = 825) living in south-eastern Sweden. A postal questionnaire included pain aspects, QoL (EQ-5D-3L, RAND-36 physical functioning, attitudes toward own aging, and life satisfaction), functional status, social networks, and basic demographic information. Pain extent and localization was obtained by digitalization of pain drawings reported on standard body charts. Most respondents were experiencing pain longer than 3 months (88.8%). Pain frequency varied mostly between occasionally (33.8%) and every day (34.8%). A minority reported high pain intensity (13.6%). The lower back and lower legs were the most frequently reported pain locations (>25%). Multiple linear regression model revealed three characteristics of pain (intensity, frequency, and extent) remained inversely associated with the EQ-5D-3L index score (R² = 0.57). Individually, each of these pain characteristics showed a negative impact on the other three dimensions of QoL (R² = 0.23–0.59). Different features of pain had impact on different dimensions of QoL in this aging population. A global pain assessment is useful to facilitate individual treatment and rehabilitation strategies in primary care.

• aging
• pain drawing
• pain extent
• primary care
• quality of life
• vulnerable

• Aged
• Aged, 80 and over
• Health Status
• Hospitalization
• Humans
• Pain
• Quality of Life
• Surveys and Questionnaires
• Sweden/epidemiology

• Dorsal root ganglion stimulation
• painful polyneuropathy
• peripheral neuropathy

Digital pain mapping allows for remote and ecological momentary assessment in patients over multiple time points spanning days to months. Frequent ecological assessments may reveal tendencies and fluctuations more clearly and provide insights into the trajectory of a patient’s pain.

The primary aim of this study is to remotely map and track the intensity and distribution of pain and discomfort (eg, burning, aching, and tingling) in patients with nonmalignant spinal referred pain over 12 weeks using a web-based app for digital pain mapping. The secondary aim is to explore the barriers of use by determining the differences in clinical and user characteristics between patients with good (regular users) and poor (nonregular users) reporting compliance.

Patients (N=91; n=53 women) with spinal referred pain were recruited using web-based and traditional in-house strategies. Patients were asked to submit weekly digital pain reports for 12 weeks. Each pain report consisted of digital pain drawings on a pseudo–three-dimensional body chart and pain intensity ratings. The pain drawings captured the distribution of pain and discomfort (pain quality descriptors) expressed as the total extent and location. Differences in weekly pain reports were explored using the total extent (pixels), current and usual pain intensity ratings, frequency of quality descriptor selection, and Jaccard similarity index. Validated e-questionnaires were completed at baseline to determine the patients’ characteristics (adapted Danish National Spine Register), disability (Oswestry Disability Index and Neck Disability Index), and pain catastrophizing (Pain Catastrophizing Scale) profiles. Barriers of use were assessed at 6 weeks using a health care–related usability and acceptance e-questionnaire and a self-developed technology-specific e-questionnaire to assess the accessibility and ease of access of the pain mapping app. Associations between total extent, pain intensity, disability, and catastrophizing were explored to further understand pain. Differences between regular and nonregular users were assessed to understand the pain mapping app reporting compliance.

Fluctuations were identified in pain reports for total extent and pain intensity ratings (P<.001). However, quality descriptor selection (P=.99) and pain drawing (P=.49), compared using the Jaccard index, were similar over time. Interestingly, current pain intensity was greater than usual pain intensity (P<.001), suggesting that the timing of pain reporting coincided with a more intense pain experience than usual. Usability and acceptance were similar between regular and nonregular users. Regular users were younger (P<.001) and reported a larger total extent of pain than nonregular users (P<.001).

This is the first study to examine digital reports of pain intensity and distribution in patients with nonmalignant spinal referred pain remotely for a sustained period and barriers of use and compliance using a digital pain mapping app. Differences in age, pain distribution, and current pain intensity may influence reporting behavior and compliance.

• disease progression
• eHealth
• mHealth
• medical illustrations
• mobile phone
• musculoskeletal pain
• pain management
• pain measurement
• pain perception
• patient-reported outcome measures
• surveys and questionnaires

• chronic pain
• pain drawing
• pain extent
• patient-reported outcome measures