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Musculoskeletal Bibliography

titleBio-psychosocial determinants of persistent pain 6 months after non-life-threatening acute orthopaedic trauma
typearticle in a journal
pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/20439055
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noteHow often does injury lead to chronic pain? Why do some injured people develop chronic pain and others do not? Researchers kept tabs on 168 patients who suffered non-life-threatening orthopaedic injuries.

54% reported persistent pain six months after the injury and 87% reported that this pain interfered with their normal work activities.

Long-term pain was more likely to the extent that pain was acute at the beginning (independently of injury severity), if patients felt responsible for the injury, and if they were pessimistic or emotionally traumatized. “Psychosocial factors strongly predicted persistent pain, pain-related work disability, and pain severity,” the researchers concluded, and noted that “many of these factors are potentially modifiable and should alert the clinician about the need for interventions in order to prevent the development of pain chronicity.”
authorsFiona J Clay, Stuart V Newstead, Wendy L Watson, Joan Ozanne-Smith, Jonathon Guy, and Roderick J McClure
keywordspain
journalJournal of Pain
year2010
monthMay
volume11
number5
pages420-30
abstractThe study quantifies the association between a range of bio-psychosocial factors and the presence of persistent pain, pain severity and pain interfering with normal work activities in a cohort of 168 patients with a range of non-life-threatening orthopaedic injuries. Participants were recruited following presentation to 1 of 4 Victoria hospitals for treatment for their injury and followed until 6 months postinjury.

Multivariate analysis was employed to determine factors associated with pain outcomes, 6 months postinjury. The prevalence of pain was common; 54% of participants reported the presence of persistent pain at 6 months, with the majority (87%) reporting that pain interfered to an extent with their normal work activities. High initial pain, external attributions of responsibility for the injury, and psychological distress were found to be significant independent predictors of the presence of all 3 outcomes. In addition, poor recovery expectations was found to be a significant predictor of pain-related work disability and being injured at work a significant predictor of pain severity. Many of these factors are potentially modifiable and should alert the clinician about the need for interventions in order to prevent the development of pain chronicity.

PERSPECTIVE: This study has quantified determinants of pain, 6 months after non-life-threatening acute orthopaedic trauma. Psychosocial factors strongly predicted persistent pain, pain-related work disability, and pain severity. These findings may assist clinicians to determine the need for, and likely effectiveness of, individual pain-management approaches in this population.