Journal of Pain最新文献_第3页

Prevalence of low back pain in Nepal: Results from a nationally representative WHO STEPS survey

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-25 DOI: 10.1016/j.jpain.2025.105352

Sweekriti Sharma , Adrian C. Traeger , Chris G. Maher , Bihungum Bista , Meghnath Dhimal , Lonim P. Dixit , Saurab Sharma

Low back pain is the leading cause of disability globally. Most prevalence data for low back pain come from high-income countries. Data from low-and middle-income countries such as Nepal are currently lacking. This study aimed to estimate one-month prevalence of low back pain in Nepal using a nationally representative sample and present the prevalence estimates by socio-demographic characteristics. We used national population-based survey data from the World Health Organisation (WHO) STEPwise Approach to Non-communicable Disease Risk Factor Surveillance (STEPS) survey conducted in Nepal from February to May 2019 with people aged 15 to 69 years. We reported the age-standardised low back pain prevalence (95% CI). We used univariate and multivariable logistic regression to assess the associations between sociodemographic variables and the presence of low back pain and results were presented as odds ratios. A total of 5593 people aged 15 to 69 years participated in the survey. The response rate was 86.4%. The age-standardised prevalence of activity limiting low back pain was 23.2% (95% CI: 21.9% to 24.5%). Older people were more likely to have low back pain than younger people. For example, people aged 55–69 years had over 4 times higher odds of having low back pain than people aged 15–24 years [odds ratio: 4.06 (95%CI= 2.57 to 6.42)]. Females had 1.74 times higher odds of having low back pain than males [odds ratio: 1.74 (95%CI= 1.45 to 2.09)]. The results of our study show that a quarter of adults are affected by low back pain in Nepal; with women and older people more likely to experience low back pain.

Perspective

This study shows that a quarter of adults are affected by low back pain in Nepal. Women and older people are more likely to experience back pain in Nepal.

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引用次数: 0

Equity Using Interventions for Pain and Depression (EQUIPD): A pilot randomized trial

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-25 DOI: 10.1016/j.jpain.2025.105353

Marianne S. Matthias Ph.D. , Diana J. Burgess Ph.D. , Joanne K. Daggy Ph.D. , Claire E. Donnelly M.A. , Perla Flores B.S. , Nicole R. Fowler Ph.D., M.H.S.A. , Jennifer Garabrant B.S.W. , Nancy Henry B.A. , Stephen G. Henry M.D. , Monica Huffman B.S. , Pavani Jyothi Kavuri M.S. , Susan Ofner M.S. , Canaan Perry B.S. , Kevin L. Rand Ph.D. , Maria Robles M.D. , Michelle P. Salyers Ph.D. , Stephanie L. Taylor Ph.D. , Adam T. Hirsh Ph.D.

Despite increased calls for improved health equity, Black patients continue to experience worse pain and associated outcomes. Black patients are also offered fewer pain treatment options than White patients and report poorer quality communication with clinicians, including lower participation in shared decision-making. Comorbid depressive symptoms can impede effective pain management and participation in decision-making. The Equity Using Interventions for Pain and Depression (EQUIPD; NCT05695209) pilot study examined feasibility of a one-on-one coaching intervention, paired with a decision aid, to facilitate shared decision-making about evidence-based nonpharmacological pain treatments for Black patients with chronic musculoskeletal pain and symptoms of at least mild depression. We recruited and randomized 30 participants at a rate of 7.5 per month, with 90% retention at 3 months and 87% at 6 months. Intervention participation was high, with 94% of participants completing at least 3 of 4 coaching sessions. Fidelity was also high. Although not powered for effectiveness, most outcomes, including pain interference, depression, anxiety, patient engagement, and shared decision-making, improved, favoring the intervention, with effect sizes ranging from 0.30–0.75 at 3 months. Results indicate that EQUIPD holds promise as an intervention to support autonomy and shared decision-making for Black patients with chronic pain and elevated depressive symptoms.

Perspective

The EQUIPD intervention, which included one-on-one coaching combined with a decision aid to increase shared decision-making about nonpharmacological pain treatments, was feasible and shows promise in improving pain and related outcomes for Black patients with chronic musculoskeletal pain and depressive symptoms.

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引用次数: 0

Corrigendum to “Hyperbaric oxygen attenuates chronic postsurgical pain by regulating the CD73/adenosine/A1R axis of the spinal cord in rats” [J Pain 25, 2024, 104623]

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-17 DOI: 10.1016/j.jpain.2025.105325

Lijun Yin , Wenwu Liu , Zhe Zhang , Jingyue Zhang , Hui Chen , Lize Xiong

引用次数: 0

Transgenic mice with a global depletion of toll-like receptor type 4 are largely protected from peripheral and central posttraumatic neuroinflammation

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-15 DOI: 10.1016/j.jpain.2025.105340

Silke Hirsch , Theodora Kalpachindou , Tanja Schlereth , Michaela Kress , Frank Birklein

Experimental bone fracture induces a posttraumatic inflammatory reaction which is characterized by local swelling, increased temperature, tenderness, thermal hypersensitivity and pain at the lesion site. As a consequence, some patients develop complex regional pain syndrome (CRPS), a chronic pain condition which often starts with exacerbating inflammation of the limb. The transmembrane receptor Toll-like receptor type 4 (TLR4) plays a central role in the innate immune response and not only engages with extracellular but also intracellular ligands, initiating intricate intracellular signaling cascades promoting inflammation. Depletion of TLR4 specifically in microglia attenuates posttraumatic pain, especially in males. Here, it is shown that male mice lacking TLR4 develop less inflammation after distal bone fracture, with attenuated swelling, local warming, macrophage invation into the dorsal root ganglion and spinal activation of microglia. Furthermore, expression of neuroinflammatory markers such as NGF, TNFα, ATF3 and Il4rα, is reduced in dorsal root ganglia. Together, the results support a proinflammatory role of TLR4 after distal bone fracture possibly initiating mechanisms leading to complex regional pain syndrome development in some patients which may be a promising novel for analgesic drug development.

Perspective

TLR4 is causally involved in the development of posttraumatic neuroinflammation characterised by upregulation of inflammatory mediators, invasion of macrophages into the dorsal root ganglion, as well as activation of microglia changes in the spinal dorsal horn in a murine model of human complex regional pain syndrome.

{"title":"Transgenic mice with a global depletion of toll-like receptor type 4 are largely protected from peripheral and central posttraumatic neuroinflammation","authors":"Silke Hirsch , Theodora Kalpachindou , Tanja Schlereth , Michaela Kress , Frank Birklein","doi":"10.1016/j.jpain.2025.105340","DOIUrl":"10.1016/j.jpain.2025.105340","url":null,"abstract":"<div><div>Experimental bone fracture induces a posttraumatic inflammatory reaction which is characterized by local swelling, increased temperature, tenderness, thermal hypersensitivity and pain at the lesion site. As a consequence, some patients develop complex regional pain syndrome (CRPS), a chronic pain condition which often starts with exacerbating inflammation of the limb. The transmembrane receptor Toll-like receptor type 4 (TLR4) plays a central role in the innate immune response and not only engages with extracellular but also intracellular ligands, initiating intricate intracellular signaling cascades promoting inflammation. Depletion of TLR4 specifically in microglia attenuates posttraumatic pain, especially in males. Here, it is shown that male mice lacking TLR4 develop less inflammation after distal bone fracture, with attenuated swelling, local warming, macrophage invation into the dorsal root ganglion and spinal activation of microglia. Furthermore, expression of neuroinflammatory markers such as NGF, TNFα, ATF3 and Il4rα, is reduced in dorsal root ganglia. Together, the results support a proinflammatory role of TLR4 after distal bone fracture possibly initiating mechanisms leading to complex regional pain syndrome development in some patients which may be a promising novel for analgesic drug development.</div></div><div><h3>Perspective</h3><div>TLR4 is causally involved in the development of posttraumatic neuroinflammation characterised by upregulation of inflammatory mediators, invasion of macrophages into the dorsal root ganglion, as well as activation of microglia changes in the spinal dorsal horn in a murine model of human complex regional pain syndrome.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105340"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of manual therapy combined with therapeutic exercise on brain structure in patients with chronic nonspecific neck pain: A randomized controlled trial

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-15 DOI: 10.1016/j.jpain.2025.105336

Rungtawan Chaikla , Munlika Sremakaew , Suwit Saekho , Suchart Kothan , Sureeporn Uthaikhup

This trial aimed to investigate the effects of 10-week manual therapy combined with exercise compared to routine physical therapy on brain structure and clinical outcomes in patients with neck pain. Fifty-two participants with chronic nonspecific neck pain were randomized into either an intervention group or a control group (a 1:1 ratio). The intervention group received cervical mobilization and cervical and scapular exercises. The control group received routine physical therapy. The primary outcomes were cortical thickness and volume. Secondary outcomes were neck pain intensity, disability, psychological symptoms, cervical range of motion and cervical flexor muscle strength. Outcome measures were taken at baseline and post-treatment. There was no loss to follow-up. Compared to baseline, significant differences in cortical thickness were observed at post-treatment in both groups, including prefrontal cortex (PFC), anterior cingulate cortex (ACC), primary somatosensory cortex (S1), primary motor cortex (M1) and precuneus (p<0.05). The intervention group exhibited greater increases in cortical thickness in the ACC and M1 compared to controls (p<0.05). The secondary outcomes were improved in both groups (p<0.05). There were differences in brain structure (S1, PFC and insula) between participants who experienced ≥50% reduction in pain intensity and those with <50% reduction (p<0.05). Changes in brain structure were correlated with changes in pain intensity and neck disability (r =−0.31 to −0.44, p<0.05). The study suggests that patients with chronic nonspecific neck pain who experienced significant improvements in pain intensity exhibited greater changes in cortical structure following a 10-week intervention, particularly with a combination of manual therapy and exercise.

Perspective

A combination of manual therapy and exercise results in greater improvements in clinical outcomes and substantially alters cortical thickness compared to routine physical therapy in patients with chronic nonspecific neck pain. These findings highlight the potential impact of this intervention on both brain structure and clinical recovery.

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引用次数: 0

Associations of ethnic identity, religiosity, discrimination, and injustice appraisal with pain-related outcomes in arab americans with chronic back pain.

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-15 DOI: 10.1016/j.jpain.2025.105337

Albatool H Alnojeidi, Carmen E Capo-Lugo, John A Sturgeon, Zina Trost

This study sought to examine the moderating roles of ethnic identity, acculturation, and religiosity on the relationship between pain-related injustice appraisal and chronic low back pain (CLBP) outcomes among a sample of Arab-Americans, who are an underrepresented population in prior pain research. The study also aimed to examine the mediating effect of pain-related injustice appraisal in the relationship between discrimination and CLBP outcomes. The sample included 96 Arab-American adults who completed an online survey concerning their CLBP. Multiple regression was used to examine the moderating role of ethnic identity, acculturation, and religiosity on the relationship between injustice appraisal and disability and depression. Findings showed that ethnic identity (β = 0.43, p = 0.03) and religiosity (β = 0.28, p = 0.04), but not acculturation, buffered the relationship between pain-related injustice appraisal and CLBP-related depressive symptoms. Perceived discrimination predicted higher pain intensity (β = 0.28), disability (β = 0.56), and depressive symptoms (β = 0.51). Pain-related injustice appraisal significantly mediated the relationship between discrimination and CLBP-related disability (β = 0.24, p < 0.0001), and depressive symptoms (β = 0.22, p < 0.0001). The current study is the first to examine the role of unique ethnic characteristics, namely ethnic identity, acculturation, and religiosity, within the context of pain-related injustice appraisal. The results support the role of broader sociocultural and societal factors, such as ethnic-based discrimination, within the context of pain-related injustice appraisal as well as the influence of intra- and interpersonal factors and their interactions on pain-related injustice appraisal. PERSPECTIVE: This study is the first to demonstrate the unique role of ethnic identification, acculturation, and religiosity within the concept of pain-related injustice appraisal, specifically among Arab-Americans with chronic low back pain. This understanding could potentially help basic researchers, clinical scientists, as well as clinicians.

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引用次数: 0

Chronic musculoskeletal pain and its association with cognitive function and sarcopenia in older adults: Characterization and change over three months

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-15 DOI: 10.1016/j.jpain.2025.105341

David Oliveira MSc , Júlia Costa PhD , Maria H. Marques MSc , Anabela G. Silva PhD

Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites – body chart, pain phenotype – PainDETECT, severity and disability – BPI, pain catastrophizing – PCS, and kinesiophobia – Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60; 22.34); Asymptomatic = 21.75 (20.89; 22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41; 3.37); Asymptomatic=0.50 (0.32; 0.68)) and lower hand grip strength (Pain=24.01 (21.74; 26.29); Asymptomatic=27.98 (25.80; 30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26; 35.79); Asymptomatic=34.55 (33.86; 35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition.

Perspective

This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.

{"title":"Chronic musculoskeletal pain and its association with cognitive function and sarcopenia in older adults: Characterization and change over three months","authors":"David Oliveira MSc , Júlia Costa PhD , Maria H. Marques MSc , Anabela G. Silva PhD","doi":"10.1016/j.jpain.2025.105341","DOIUrl":"10.1016/j.jpain.2025.105341","url":null,"abstract":"<div><div>Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites – body chart, pain phenotype – PainDETECT, severity and disability – BPI, pain catastrophizing – PCS, and kinesiophobia – Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60; 22.34); Asymptomatic = 21.75 (20.89; 22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41; 3.37); Asymptomatic=0.50 (0.32; 0.68)) and lower hand grip strength (Pain=24.01 (21.74; 26.29); Asymptomatic=27.98 (25.80; 30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26; 35.79); Asymptomatic=34.55 (33.86; 35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition.</div></div><div><h3>Perspective</h3><div>This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.</div></div>","PeriodicalId":51095,"journal":{"name":"Journal of Pain","volume":"29 ","pages":"Article 105341"},"PeriodicalIF":4.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Self-rated pain and observed pain behavior in Black and White Americans with chronic low back pain

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-12 DOI: 10.1016/j.jpain.2025.105338

Matthew B. Jennings , John W. Burns , Benita Jackson , Kristine M. Molina , Mark A. Lumley

Black Americans report more intense and disabling pain than White Americans, but differences in pain behavior have rarely been studied. The Structured Pain Behavior Test (SPBT), a standardized, video-recorded series of pain-inducing movements, assesses the behavioral expression of pain. We conducted the first test of whether Black Americans with chronic low back pain (CLBP) have greater pain behavior and increased self-reported pain intensity during the SPBT, compared to White Americans. Adults (N = 267) with CLBP (174 Black, 93 White; 57% female) rated their clinical pain severity and interference (Multidimensional Pain Inventory; MPI) and their current pain intensity (Numerical Rating Scale; NRS) both before and after engaging in the SPBT, which was coded for observed pain behavior. Consistent with prior research, Black participants reported greater MPI clinical pain severity and interference (large effect). More importantly, during the SPBT, Black participants had greater pain behavior (medium effect) and reported a greater increase in pain intensity (NRS; small-medium effect) than did Whites. Racialized differences in all pain measures remained significant after controlling for multiple variables (including depressive symptoms and pain catastrophizing), and differences in observed pain behavior remained after also controlling for self-reported pain intensity (NRS) or MPI clinical pain severity. We conclude that greater self-reported pain severity and interference among Black Americans is accompanied by greater pain behavior and increased pain intensity in response to pain-inducing movements. Research should examine possible mechanisms of this racialized difference, including differential access and care, racism as pain exacerbator, and the social communication of pain.

Perspective

Black Americans with chronic back pain have greater self-reported pain severity than White Americans and greater pain behavior during the Structured Pain Behavior Test, even after controlling for self-reported pain and other variables. Black Americans’ elevated pain may reflect poorer health care, racism-induced pain exacerbation, and/or social communication of need.

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引用次数: 0

Experimentally induced pain and paresthesia respond differently to parameter changes of cuff-based compression in pain-free young individuals

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-12 DOI: 10.1016/j.jpain.2025.105339

Jacek Skalski , Sylwia Swoboda , Tibor M. Szikszay , Piotr Wodarski , Andrzej Bieniek , Kerstin Luedtke , Wacław M. Adamczyk

Neuropathic pain is a significant therapeutic challenge due to the co-occurrence with other neurological symptoms such as paresthesia. Human-based models such as cuff algometry can enhance our understanding of pain-paresthesia relationships. This experiment aimed to characterize (psychophysically) pain and paresthesia evoked by stimuli of different temporal and intensity parameters and to demonstrate the reliability of experimental induction of these two symptoms using cuff algometry. Forty participants, aged 18–35, were exposed to mechanical pressure stimuli at three intensities (100, 150, 200 mmHg) and three durations (90, 120, 150 s). Skin Conductance (SC) was continuously monitored, and participants rated pain and paresthesia in real-time using a computerized visual analog scale. The General Linear Model analysis revealed significant differences in paresthesia across all durations (p<0.01), but not all intensities, as paresthesia did not increase from 150 to 200 mmHg (p>0.05). Conversely, pain responses showed significant differences across all pressure intensities (p<0.05) but not durations, as pain did not increase from 90 to 120 and from 120 to 150 s (p>0.05). No interaction effects were found for either symptom. SC analysis showed no significant main or interaction effects. Intraclass correlation coefficients (ICCs) indicated moderate to excellent reliability for pain and paresthesia induction across different durations and intensities (ICC: 0.51–0.91), while SC showed poor to good reliability (ICC: 0.17–0.79). In conclusion, computerized cuff algometry seems to be an effective and reliable method for simultaneously inducing and assessing pain and paresthesia, revealing that these symptoms follow different patterns based on pressure duration and intensity.

Perspective

This study demonstrates that pain and paresthesia respond differently to varying intensities and durations of mechanical pressure, revealing their distinct psychophysical characteristics. This model can advance the understanding of neuropathic conditions and aid the development of more targeted therapeutic approaches for both pain and paresthesia.

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引用次数: 0

Using intensive longitudinal assessment to study mechanisms of the Native American pain inequity among persons experiencing depression and/or anxiety: The role of interpersonal discrimination and stress

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain

Pub Date : 2025-02-12 DOI: 10.1016/j.jpain.2025.105329

Jamie L. Rhudy PhD , Joanna O. Shadlow PhD , Travis S. Lowe PhD , Lancer D. Stephens PhD , Michael J. Zvolensky PhD , Lorra Garey PhD , Darla E. Kendzor , Michael S. Businelle PhD

Native Americans (NA) experience higher rates of chronic pain than other U.S. racial/ethnic groups. Our research has indicated discrimination and stress play a role in chronic pain onset. However, chronic pain research has mostly relied on retrospective reports that may be impacted by recall bias. The current study was a secondary analysis of data from 208 NA, 206 Black, 202 Latinx, and 206 non-Hispanic White (NHW) participants from an efficacy trial of a mobile health intervention for depression and anxiety. Participants were prompted to complete 6 months of twice daily ecological momentary assessments (EMAs) that included stress and pain. Discrimination was assessed at baseline. Pain EMAs were used to reduce recall bias and estimate chronic pain prevalence. Dynamic structural equation modeling assessed the impact of race/ethnicity and discrimination on stress-pain relationships, as well as pain and stress dynamics. To assess chronic pain (pain ≥3-months), participants had to complete ≥3-months of consecutive EMAs, leaving 578 participants available for primary analyses (there were no racial/ethnic differences in EMA completion). Results showed NAs had the highest rate of chronic pain that was statistically significantly higher than NHW and Black participants. Controlling discrimination eliminated the NA-NHW, but not the NA-Black, pain inequity. Moreover, a reciprocal stress-pain relationship was found and was stronger in NAs than other groups. Discrimination did not exacerbate stress-pain relationships but was associated with higher rates of chronic pain and greater pain fluctuations, regardless of race/ethnicity. These findings indicate that targeting stress and discrimination could help reduce the NA pain inequity.

Perspective

Native Americans experienced a self-reinforcing stress-pain cycle in which stress predicted future pain and pain predicted future stress. This cycle was stronger than Black, Latinx, and non-Hispanic White groups. Discrimination was associated with chronic pain but not stronger stress-pain relationships. These findings have implications for treatment.

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引用次数: 0