Anamnestic characteristics of chronic pain development
DOI:
https://doi.org/10.6016/ZdravVestn.3345Keywords:
chronic widespread pain, fibromyalgia syndrome, descriptors, cross-sectional studyAbstract
Background: There is little knowledge about possible trajectories of chronic pain development, especially in relation to other common symptoms (sleep and vitality). By analysing patients’ medical records and other available clinical data, we aimed to identify specific developmental patterns of pain and other symptoms and to explore possible differences between such groups of patients.
Methods: We included 487 consecutive patients aged 18+ years who attended the specialist outpatient clinic for chronic non-malignant pain for rehabilitation from February until November 2019. We used 16 binary descriptors to characterise symptom development. Participants completed two questionnaires about pain. We used clinically available data on previous and concurrent medical conditions, motor ability tests, body mass index, medication, and socioeconomic status.
Results: The majority of the participants reported persistent low-back pain occurring first. One-third of them reported an estimated duration of daily pain below 5 years; 16% reported it to be over 20 years. Only one-third of the participants reported no concomitant headache. Hierarchical clustering based on descriptors identified three distinct groups; the fourth group consisted of those with an unclear history. The data on concomitant diseases revealed a wide array of diagnoses not usually associated with pain syndromes.
Conclusion: Based on the patients’ medical histories, we uncovered some possible trajectories of chronic pain syndrome development in relation to basic symptoms (widespread pain, headache, physical or mental fatigue, sleep disorders). Improving the understanding of chronic pain development could contribute to discovering the key pathophysiological mechanisms and to more targeted, effective, and earlier interventions in its treatment.
Downloads
References
1. Phillips CJ. The Cost and Burden of Chronic Pain. Rev Pain. 2009;3(1):2-5.
DOI: 10.1177/204946370900300102
PMID: 26526940
2. Gaskin DJ, Richard P. The economic costs of pain in the United States. J Pain. 2012;13(8):715-24.
DOI: 10.1016/j.jpain.2012.03.009
PMID: 22607834
3. Leadley RM, Armstrong N, Reid KJ, Allen A, Misso KV, Kleijnen J. Healthy aging in relation to chronic pain and quality of life in Europe. Pain Pract. 2014;14(6):547-58.
DOI: 10.1111/papr.12125
PMID: 24138082
4. Gatchel RJ, Bevers K, Licciardone JC, Su J, Du Y, Brotto M. Transitioning from Acute to Chronic Pain: An Examination of Different Trajectories of Low-Back Pain. Healthcare (Basel). 2018;6(2):48.
DOI: 10.3390/healthcare6020048
PMID: 29772754
5. Creed F. A review of the incidence and risk factors for fibromyalgia and chronic widespread pain in population-based studies. Pain. 2020;161(6):1169-76.
DOI: 10.1097/j.pain.0000000000001819
PMID: 32040078
6. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319-29.
DOI: 10.1016/j.semarthrit.2016.08.012
PMID: 27916278
7. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72.
DOI: 10.1002/art.1780330203
PMID: 2306288
8. Chen JH, Chen HJ, Kao CH, Tseng CH, Tsai CH. Is Fibromyalgia Risk Higher Among Male and Young Inflammatory Bowel Disease Patients? Evidence from a Taiwan Cohort of One Million. Pain Physician. 2018;21(3):E257-64.
PMID: 29871388
9. Vincent A, Hoskin TL, Whipple MO, Clauw DJ, Barton DL, Benzo RP, et al. OMERACT-based fibromyalgia symptom subgroups: an exploratory cluster analysis. Arthritis Res Ther. 2014;16(5):463.
DOI: 10.1186/s13075-014-0463-7
PMID: 25318839
10. Choi CJ, Knutsen R, Oda K, Fraser GE, Knutsen SF. The association between incident self-reported fibromyalgia and nonpsychiatric factors: 25-years follow-up of the Adventist Health Study. J Pain. 2010;11(10):994-1003.
DOI: 10.1016/j.jpain.2010.01.267
PMID: 20400378
11. Penn IW, Chuang E, Chuang TY, Lin CL, Kao CH. Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations. BMJ Open. 2019;9(4):e026581.
DOI: 10.1136/bmjopen-2018-026581
PMID: 30962236
12. Wang JC, Sung FC, Men M, Wang KA, Lin CL, Kao CH. Bidirectional association between fibromyalgia and gastroesophageal reflux disease: two population-based retrospective cohort analysis. Pain. 2017;158(10):1971-8.
DOI: 10.1097/j.pain.0000000000000994
PMID: 28683023
13. Hagen K, Linde M, Steiner TJ, Zwart JA, Stovner LJ. The bidirectional relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the Nord-Trøndelag Health Study (HUNT). Eur J Neurol. 2012;19(11):1447-54.
DOI: 10.1111/j.1468-1331.2012.03725.x
PMID: 22519547
14. Häuser W, Perrot S, Sommer C, Shir Y, Fitzcharles MA. Diagnostic confounders of chronic widespread pain: not always fibromyalgia. Pain Rep. 2017;2(3):e598.
DOI: 10.1097/PR9.0000000000000598
PMID: 29392213
15. Haliloglu S, Ekinci B, Uzkeser H, Sevimli H, Carlioglu A, Macit PM. Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity. Clin Rheumatol. 2017;36(7):1617-21.
DOI: 10.1007/s10067-017-3556-2
PMID: 28176037
16. Abuhasira R, Zlotnik Y, Horev A, Ifergane G. Fibromyalgia-Like Syndrome Associated with Parkinson’s Disease-A Cohort Study. J Clin Med. 2019;8(8):1118.
DOI: 10.3390/jcm8081118
PMID: 31357683
17. Cai T, Abel L, Langford O, Monaghan G, Aronson JK, Stevens RJ, et al. Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses. BMJ. 2021;374(1537):n1537.
DOI: 10.1136/bmj.n1537
PMID: 34261627
18. König SL, Prusak M, Pramhas S, Windpassinger M. Correlation between the Neuropathic PainDETECT Screening Questionnaire and Pain Intensity in Chronic Pain Patients. Medicina (Kaunas). 2021;57(4):353.
DOI: 10.3390/medicina57040353
PMID: 33916898
19. Greenbaum H, Weil C, Chodick G, Shalev V, Eisenberg VH. Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases. Am J Reprod Immunol. 2019;81(4):e13095.
DOI: 10.1111/aji.13095
PMID: 30682223
20. Brooks L, Hadi J, Amber KT, Weiner M, La Riche CL, Ference T. Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue? J Pain Res. 2015;8:561-9.
DOI: 10.2147/JPR.S86573
PMID: 26316807
21. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27.
DOI: 10.1097/j.pain.0000000000001384
PMID: 30586067
22. Landmark T, Romundstad P, Butler S, Kaasa S, Borchgrevink P. Development and course of chronic widespread pain: the role of time and pain characteristics (the HUNT pain study). Pain. 2019;160(9):1976-81.
DOI: 10.1097/j.pain.0000000000001585
PMID: 30985619
23. Harkness EF, Macfarlane GJ, Nahit ES, Silman AJ, McBeth J. Mechanical and psychosocial factors predict new onset shoulder pain: a prospective cohort study of newly employed workers. Occup Environ Med. 2003;60(11):850-7.
DOI: 10.1136/oem.60.11.850
PMID: 14573715
24. Goebel A, Krock E, Gentry C, Israel MR, Jurczak A, Urbina CM, et al. Passive transfer of fibromyalgia symptoms from patients to mice. J Clin Invest. 2021;131(13):e144201.
DOI: 10.1172/JCI144201
PMID: 34196305
25. Rahman MS, Winsvold BS, Chavez Chavez SO, Børte S, Tsepilov YA, Sharapov SZ, et al.; HUNT All-In Pain. Genome-wide association study identifies RNF123 locus as associated with chronic widespread musculoskeletal pain. Ann Rheum Dis. 2021;80(9):1227-35.
DOI: 10.1136/annrheumdis-2020-219624
PMID: 33926923
26. D’Agnelli S, Arendt-Nielsen L, Gerra MC, Zatorri K, Boggiani L, Baciarello M, et al. Fibromyalgia: genetics and epigenetics insights may provide the basis for the development of diagnostic biomarkers. Mol Pain. 2019;15:1744806918819944.
DOI: 10.1177/1744806918819944
PMID: 30486733
27. Tan AC, Jaaniste T, Champion D. Chronic Widespread Pain and Fibromyalgia Syndrome: Life-Course Risk Markers in Young People. Pain Res Manag. 2019;2019:6584753.
DOI: 10.1155/2019/6584753
PMID: 31191788
28. Fishbain DA, Pulikal A, Lewis JE, Gao J. Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review. Pain Med. 2017;18(4):711-35.
DOI: 10.1093/pm/pnw065
PMID: 27188666
29. Brockie TN, Dana-Sacco G, Wallen GR, Wilcox HC, Campbell JC. The Relationship of Adverse Childhood Experiences to PTSD, Depression, Poly-Drug Use and Suicide Attempt in Reservation-Based Native American Adolescents and Young Adults. Am J Community Psychol. 2015;55(3-4):411-21.
DOI: 10.1007/s10464-015-9721-3
PMID: 25893815
30. Nicolson NA, Davis MC, Kruszewski D, Zautra AJ. Childhood maltreatment and diurnal cortisol patterns in women with chronic pain. Psychosom Med. 2010;72(5):471-80.
DOI: 10.1097/PSY.0b013e3181d9a104
PMID: 20467005
31. Brown RC, Plener PL, Braehler E, Fegert JM, Huber-Lang M. Associations of adverse childhood experiences and bullying on physical pain in the general population of Germany. J Pain Res. 2018;11:3099-108.
DOI: 10.2147/JPR.S169135
PMID: 30584352
32. Tietjen GE, Brandes JL, Peterlin BL, Eloff A, Dafer RM, Stein MR, et al. Childhood maltreatment and migraine (part II). Emotional abuse as a risk factor for headache chronification. Headache. 2010;50(1):32-41.
DOI: 10.1111/j.1526-4610.2009.01557.x
PMID: 19845781
33. Stickley A, Koyanagi A, Kawakami N; WHO World Mental Health Japan Survey Group. Childhood adversities and adult-onset chronic pain: Results from the World Mental Health Survey, Japan. Eur J Pain. 2015;19(10):1418-27.
DOI: 10.1002/ejp.672
PMID: 25736867
34. Albrecht DS, Forsberg A, Sandström A, Bergan C, Kadetoff D, Protsenko E, et al. Brain glial activation in fibromyalgia - A multi-site positron emission tomography investigation. Brain Behav Immun. 2019;75:72-83.
DOI: 10.1016/j.bbi.2018.09.018
PMID: 30223011
35. Natelson BH, Vu D, Coplan JD, Mao X, Blate M, Kang G, et al. Elevations of Ventricular Lactate Levels Occur in Both Chronic Fatigue Syndrome and Fibromyalgia. Fatigue. 2017;5(1):15-20.
DOI: 10.1080/21641846.2017.1280114
PMID: 29308330
36. Picard M, McEwen BS, Epel ES, Sandi C. An energetic view of stress: focus on mitochondria. Front Neuroendocrinol. 2018;49:72-85.
DOI: 10.1016/j.yfrne.2018.01.001
PMID: 29339091
37. Misiak B, Stańczykiewicz B, Pawlak A, Szewczuk-Bogusławska M, Samochowiec J, Samochowiec A, et al. Adverse childhood experiences and low socioeconomic status with respect to allostatic load in adulthood: A systematic review. Psychoneuroendocrinology. 2022;136:105602.
DOI: 10.1016/j.psyneuen.2021.105602
PMID: 34861465
Downloads
Published
Issue
Section
License
The Author transfers to the Publisher (Slovenian Medical Association) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Slovenian Medical Association) has the right to transfer the rights of acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
