The journal of pain : official journal of the American Pain Society
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This cross-sectional study describes chronic pain in 94 persons with multiple sclerosis residing in the community. The characteristics of chronic pain, pain-related disability, pain treatments, barriers to health care, and impact on quality of life were examined. Sixty-four percent of participants reported chronic pain; of these, 60% had dysesthetic pain and 70% had episodic increases in pain. The mean numerical pain intensity rating score was moderate (5). Chronic Pain Grade was used to classify severity of pain, using scores for items for pain intensity and pain-related disability. Those in the higher pain grades had more disability and recorded more health care visits (P = .06) (not significant because of small sample size). Effective pain management techniques included analgesic medication and physical measures as reported by 54% and 44% participants, respectively. Participants' perceived barriers to health care included environmental and personal factors. Those with multiple sclerosis and pain, compared with those with no pain, showed a significant difference in the domain of psychological well-being scores (P = .01) on the Assessment of Quality of Life scale. Additionally, the domains of independent living (P = .009) and total scores (P = .04) showed better quality of life in participants with lower pain grades. Improved understanding of chronic pain in this population may facilitate early identification for timely intervention and minimize pain-related disability. ⋯ This article describes chronic pain in persons with multiple sclerosis living in the community. The information regarding pain prevalence, pain-related disability, and impact on quality of life provides insight into the complex multidimensional pain experience. Improved understanding of pain and early intervention may contribute to the overall well-being and decrease pain-related disability in this population.
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The goal of this study was to determine the intra- and interday reliability of pressure pain thresholds (PPT) in the upper extremity and torso of asymptomatic women. Nineteen healthy women (20-39 years) with no underlying musculoskeletal problems had 3 PPT trials performed on 8 different locations in the upper extremity and torso over 4 consecutive days. The test-retest reliability of PPT values was robust and highly consistent over the 4 days. The PPT intraclass correlations (ICC) were highly consistent and repeatable over the 4 days of testing (day 1: ICC = 0.94; day 2: ICC = 0.96; day 3: ICC = 0.97 and day 4: ICC = 0.96). When compared with baseline measurements obtained on day 1, the PPT values were significantly lower (P < .05) on days 2, 3, and 4 at all 8 locations. Although the PPT test-retest reliability is robust and consistent throughout the 4 days, there appears to be a similar overall decline in the magnitude of the absolute PPT response at each of the 8 locations. A specific explanation for this greater overall sensitivity in PPTs at all 8 locations is lacking; however, a centrally mediated alteration in pressure/pain sensation could contribute to the overall trend observed in this study. ⋯ PPT measurements of the upper limb and torso will be significantly lower with repeated measures over a short period time. A standardized evaluation grid should be included in baseline so as to accurately evaluate the progression in shoulder rehabilitation in women with shoulder dysfunction.