4 research outputs found
Comparison of Pain Location and Extent Between Adults with Ankylosing Spondylitis-related Inflammatory versus Chronic Nonspecific Low Back Pain
No full textIntroduction: Pain among adults with ankylosing spondylitis-related inflammatory low back pain (AS-ILBP) is not well-characterized, and individuals with AS-ILBP are frequently misdiagnosed with chronic nonspecific low back pain (CNSLBP). This study digitally quantifies and compares the location and extent of pain between adults with AS-ILBP and those with CNSLBP and examines the relationship between the pain extent and functional, psychological, and condition-specific factors in those with AS-ILBP.
Methodology: The location and extent of pain in adults with AS-ILBP (n = 27) or CNSLBP (n = 22) was quantified using a digital pain drawing analysis. Relationships between pain extent and perceived pain intensity and disability, pain-related cognitive factors (back beliefs, fear of movement, pain catastrophizing, pain coping, and self-efficacy), psychological distress, and AS-specific features were examined in those with AS-ILBP.
Result: Pain extent in the dorsal region of the body was greater in those with AS-ILBP than in CNSLBP (P 0.05). The AS-ILBP group more frequently reported pain in the thoracic (70.4%) and cervical (51.8%) regions (P < 0.05). In the AS-ILBP group, larger pain extent was moderately associated with negative back beliefs (rs = –0.44 to –0.41, P < 0.05) and lower self-efficacy (rs = –0.58 to –0.42, P < 0.05), but not with any of functional outcomes. Larger pain extent was associated with higher disease activity (P < 0.05).
Conclusion: Adults with AS-ILBP perceive larger pain extent in spinal regions and the degree of pain extent is associated with negative back beliefs, lower self-efficacy, and higher disease activity. Pain drawings may assist in the differential diagnosis of CNSLBP and AS-ILBP. Further, they may aid psychological screening in adults with AS-ILBP
Experiences of Adults Living with Ankylosing Spondylitis-related Inflammatory Low Back Pain: A Qualitative Study
No full textIntroduction: Inflammatory low back pain (ILBP) is a key clinical symptom and a significant problem in ankylosing spondylitis (AS), its high socioeconomic costs are mainly attributed to disability. To the best of our knowledge, no study has specifically explored the ILBP experience in adults with AS. This study aimed to explore the experiences of ILBP from the perspective of adults with AS.
Methodology: This study followed a qualitative descriptive design. Participants were recruited from rheumatology and physiotherapy outpatient clinics of two major hospitals in Dublin, and from AS patient support groups in Ireland. A total of 19 adults with AS-related inflammatory low back pain (AS-ILBP) (mean age 47.8 years [SD 11.2]) participated in semi-structured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim, coded, and analyzed thematically.
Result: Analysis of experiences revealed five themes: (i) experiences and perception surrounding diagnosis, (ii) perceived ILBP trajectories, (iii) impact of AS-ILBP, (iv) behavioral responses toward ILBP, and (v) experience with AS-ILBP treatments. Adults with AS-ILBP experienced a delay in diagnosis, in which ILBP was negatively perceived, and dysfunctional LBP beliefs and behaviors were reported. ILBP appeared to have a multidimensional nature and impact, with the greatest impact suggested on physical function and psychological health. Many individuals with AS held negative ILBP beliefs that drove dysfunctional behaviors. The primary received ILBP treatment was medication and to a lesser extent physiotherapy; both described treatments had limited effects.
Conclusion: This study was the first to reveal the unique experience of ILBP from the perspective of adults with AS. AS-ILBP appear to have a varying course and a multidimensional associated factors that determine its trajectory. AS-ILBP was suggested to affect all aspects of individual's life. A bidirectional relationship between ILBP and the psychosocial factors was proposed; these factors were perceived as aggravators and consequences of ILBP. This study also points to the limitations of current AS-ILBP management, which were mainly biomedically oriented. Thus, healthcare providers are advised to incorporate a multidimensional pain screening with their routine physical assessments of adults with AS-ILBP. This could help in designing tailored individualized, effective AS-ILBP management programs
An Assessment of the Longitudinal Construct Validity of the Pain Behavioral Scale (PaBS) in a Saudi Population with Chronic Low Back Pain: A Preliminary Study
No full textBackground: The Pain Behavioral Scale (PaBS) measures the presence and severity of pain behavior. We examine the longitudinal construct validity of the PaBS using convergent and known-groups approaches on a population of 23 participants with chronic lower back pain (LBP) undergoing routine physiotherapy care and pain neuroscience education. Methods: Participants who satisfied study inclusion and exclusion criteria were recruited from patients who attended two testing sessions at physiotherapy clinics in Saudi Arabia. Participant pain behavior was initially measured using the PaBS scale; participants performed standardized physical tests (e.g., repeated trunk flexion) and provided baseline demographic, clinical data, and self-reported measurements using the Modified Roland and Morris disability questionnaire (MODI), fear-avoidance questionnaire (FABQ), and pain catastrophizing scale (PCS). In subsequent visits, a physiotherapist provided usual care to participants, and weekly sessions were established for online pain-neuroscience education. During week six, participants repeated the same questionnaires and physical performance tests with the PaBS. Paired t-tests are used to compare changes in health characteristics from baseline responses to those in week six. Correlations between changes in PaBS from baseline to week six, with changes in outcome measures (i.e., disability, pain intensity, fear-avoidance beliefs, catastrophizing), were determined. To assess known-group validity, we also used a general linear model. Results: A total of 23 participants completed the PNE and follow-up data collection. The mean change from baseline in the PaBS score was statistically significant, as were changes in MODI, FABQ, and PCS. Almost 70% of participants improved their PaBS scores over the six-week period, with PaBS scores of almost 40% of them improving by three units or more. The change in PaBS score correlated significantly with changes in the PCS-rumination subscale, supporting a proposed approach to estimate convergent validity (r = 0.44, 95% CI = 0.04–0.72, p = 0.035). Conclusions: The mean change from baseline in the PaBS score is statistically significant, as are changes in MODI, FABQ, and PCS, supporting its convergent validity. According to our STarT Back groups, the medium to low-risk group had a lower PaBS score, and high-risk group had a higher PaBS score, indicating that PaBS use in clinical assessment may identify people according to pain-behavior severity, or those at increased risk of developing disability
Prevalence and Risk Factors for Neck and Upper Limb Musculoskeletal Disabilities Among Postpartum Women
No full textBackground: Postpartum women often experience musculoskeletal pain due to physiological and biomechanical changes during pregnancy and childbirth, which can result in disability. This study assessed the prevalence of neck and upper limb pain and disability in postpartum women, as well as the factors associated with these conditions. Methods: A descriptive cross-sectional study was conducted to collect data from postpartum women through an online self-administered questionnaire. The questionnaire included items on the demographic variables, the Nordic Musculoskeletal Symptoms Questionnaire, the Neck Disability Index, the Disabilities of the Arm, Shoulder, and Hand scale, as well as the Pain Intensity Numeric Rating Scale. Results: Among a sample of 400 postpartum women aged 20–50 years, 82.5% reported experiencing pain in at least one part of their upper body. Neck pain was the most prevalent (65.5%), followed by pain in the shoulders (63.3%), arms (58.3%), and hands (57.0%). Cesarean section delivery and moderate-to-severe pain intensity were identified as significant risk factors for developing mild disability among women who reporting neck pain. Upper limb pain and being aged 41–50 years were significant risk factors for mild disabilities among postpartum women. Conclusions: Disability was prevalent among the sample of postpartum women, highlighting the importance of healthcare providers in addressing this issue
