Environmental factors and their impact on chronic pain development and maintenance

Graded anthropomorphic pain perception electronic skin

As a smart product with flexible, stretchable, and multifunctional sensing properties, electronic skin (e-skin) has made significant research progress in many fields, such as robotics, medical monitoring, and human-computer interaction. However, the current e-skin still has obvious deficiencies in simulating pain perception, especially the limitation in simulating human pain grading perception. In this study, the theory of medical pain grading is applied to the field of e-skin for the first time, and an e-skin system with gradable human-like pain perception is proposed. The system comprises a sensor perception module, an information acquisition module, a neural network processing module, and a visualization feedback module. By combining the electronic skin with neural network technology, the system not only realizes the basic pain grading function but also can adjust the adaptive pain perception according to the environmental temperature change. This study provides a feasible solution for developing graded human-like pain-sensing technology in the fields of intelligent prosthetics, medical monitoring, and human-computer interaction.

The association between solid fuel use for heating and cooking and low back pain and neck pain in middle-aged to elderly Chinese adults: a cross-sectional and panel data analysis

OBJECTIVE

In low - and middle-income countries, a large number of people still use solid fuels, including crop residues such as biofuels/wood and coal, for heating and cooking. Compared with clean fuels(electric, liquefied petroleum gas, natural gas, marsh gas and solar), solid fuels can cause numerous health hazards. There is limited evidence suggesting that the use of solid fuel is associated with self-perceived low back pain (LBP) and neck pain (NP). This study aimed to analyze the association between household solid fuel use and the risk of LBP and NP in middle aged and elderly adults.

METHODS

We used data from the China Health and Retirement Longitudinal Study for five cross-sectional and ten panel analyses. Multivariable logistic regression model and generalized estimation equation were used to elucidate the relationship between solid fuel and the number of solid fuels used and two pains(LBP and NP). Moreover, the effect of fuel type conversion on LBP and NP is also done.

RESULTS

The results indicate that users of solid fuels, particularly those using solid cooking fuels, may have a higher risk of LBP(OR: 1.13, 95% CI: 1.05-1.22 for 2011-2020) and NP(OR: 1.22, 95% CI: 1.13-1.31 for 2018-2020). The use of solid fuels for heating also raises the risk of LBP(OR: 1.15, 95% CI: 1.06-1.24 for 2011-2020) and NP(OR: 1.34, 95% CI: 1.22-1.46 for 2015-2020). Compared to complete clean fuel users, both mixed fuel and complete solid fuel users face a greater risk for LBP (OR: 1.29, 95% CI: 1.17-1.43 for complete solid fuel users) and NP(OR: 1.38, 95% CI: 1.22-1.55 for complete solid fuel users). Additionally, persistent solid fuel users and those who switch fuel types exhibit higher risks of LBP (OR: 1.33, 95% CI: 1.20-1.47 for persistent solid fuel heating; OR: 1.39, 95% CI: 1.26-1.54 for persistent solid fuel cooking) and NP (OR: 1.38, 95% CI: 1.20-1.59 for persistent solid fuel heating; OR: 1.34, 95% CI: 1.17-1.54 for persistent solid fuel cooking) than persistent clean fuel users.

CONCLUSION

Long-term exposure to household solid fuels is associated with a higher risk of LBP and NP. It is suggested that multiple departments cooperate to increase the global use of clean energy and thereby reduce the risk of LBP and NP among middle-aged and elderly people.

Reconfiguring Pain Interpretation Within a Social Model of Health Using a Simplified Version of Wilber's All Quadrant All Levels Framework: An Integral Vision

Despite the proliferation of biomedical and psychological treatments, the global burden of chronic intractable (long-term) pain remains high-a treatment-prevalence paradox. The biopsychosocial model, introduced in the 1970s, is central to strategies for managing pain, but has been criticised for being decontextualised and fragmented, compromising the effectiveness of healthcare pain support services and patient care. The aim of this study was to apply a simplified version of Ken Wilber's All Quadrant All Levels (AQAL) framework to pain in a healthcare context to advance a biopsychosocial understanding. Utilising domain knowledge, the author mapped features of pain and coping to intrasubjective, intraobjective, intersubjective, and interobjective quadrants (perspectives), as well as levels of psychological development. Narratives were crafted to synthesize the findings of mapping with literature from diverse disciplines within the contexts of salutogenesis and a social model of health. The findings showed that AQAL-mapping enhanced contextual biopsychosocial coherence and exposed the conceptual error of reifying pain. Its utility lay in highlighting upstream influences of the painogenic environment, supporting the reconfiguration of pain within a social model of health, as exemplified by the UK's Rethinking Pain Service. In conclusion, a simple version of the AQAL framework served as a heuristic device to develop an integral vision of pain, opening opportunities for health promotion solutions within a salutogenic context.

Living successfully with chronic pain: Identifying the pivotal conditions needed to make it happen

Chronic pain is associated with many negative consequences for individuals and society. Given the burden it represents, many studies have focused on the risk factors involved, but very few have aimed to explain why some people live well with chronic pain, beyond the psychological realm. Thus, this study collected and analyzed different individual experiences to identify the pivotal conditions that help some individuals achieve quality of life despite chronic pain, with an emphasis on social considerations. We conducted a qualitative study using a narrative inquiry approach to unpack the participants' stories on these pivotal conditions. We carried out 25 individual interviews with persons who considered they had been living well with their pain for a minimum of 6 months. Data were analyzed using the inductive narrative method. Most participants were women (64%), White (88%), with a high level of education, and having low back or generalized pain (56%). Three main themes were identified: 1) a care partnership, 2) a nurturing environment, and 3) breaking free from previous life to move forward. These themes were then divided into 11 sub-themes, providing an in-depth understanding of the pivotal conditions needed to live well with chronic pain. The data collected suggest that to enable people to have a favorable evolution in the presence of chronic pain, a socio-ecological approach could be necessary to counteract painogenic environments. However, these results need to be validated and adapted to different populations. Perspective This study highlights the importance of a socio-ecological approach to living well with chronic pain, emphasizing that care partnerships, a nurturing environment and the ability to break with the past are essential to improve the quality of life of those affected.

Social determinants of health and youth chronic pain

OBJECTIVES

To identify the relationships between social determinants of health (SDOH) and chronic pain among U.S. youth (referring to children and adolescents).

METHODS

Data including a national sample of U.S. youth were retrieved from the 2022 National Survey of Children's Health. Twenty indicators within five SDOH-related domains (e.i., economic stability, social and community context, neighborhood and built environment, health care access and quality, and education access and quality) were included. The presence of chronic pain was assessed using a self-reported question, answered by the main caregiver. Associations of SDOH-related indicators and youth chronic pain were estimated using multi-variable logistic regression models, while adjusting for covariates (e.g., age, sex, ethnicity, weight status, and movement behaviors).

RESULTS

Data from 30,287 U S. youth aged 6-17 years (median [SD] age, 11.59 [3.30] years; 14,582 girls [48.97 %]) were collected. In 7.5 % of the final sample size, caregivers reported that they had chronic pain. Youth grow up in conditions with diverse SDOH profiles, including food insufficiency (OR = 1.46, 95 % CI: 1.01 to 2.10) and parental unemployment (OR = 1.56, 95 % CI: 1.15 to 2.12); low school engagement (OR = 1.48, 95 % CI: 1.14 to 1.92) and low school safety (OR = 1.65, 95 % CI: 1.14 to 2.39); limited access to quality health care (OR = 2.56, 95 % CI: 2.12 to 3.09), a high frequency of hospital visits (OR = 4.76, 95 % CI: 1.82 to 12.44), and alternative health care (OR = 2.57, 95 % CI: 2.07 to 3.20); bullying victimization (OR = 1.37, 95 % CI: 1.11 to 1.68) and community-based adverse childhood experiences (OR = 1.64, 95 % CI: 1.32 to 2.05); and disadvantageous amenity characteristics (OR = 1.38, 95 % CI: 1.05 to 1.79); resulted in higher odds of presenting chronic pain.

CONCLUSIONS

Different indicators included in the SDOH domains were associated with a higher probability of presenting chronic pain in U.S youth. These findings have implied relationships between the SDOH and chronic pain in youth, requiring a comprehensive approach to addressing health equity to prevent and reduce the presence of youth chronic pain.

Neuropathic pain, mood, and stress-related disorders: A literature review of comorbidity and co-pathogenesis

Neuropathic pain can be caused by multiple factors, and its prevalence can reach 10% of the global population. It is becoming increasingly evident that limited or short-lasting response to treatments for neuropathic pain is associated with psychological factors, which include psychiatric comorbidities known to affect quality of life. It is estimated that 60% of patients with neuropathic pain also experience depression, anxiety, and stress symptoms. Altered mood, including stress, can be a consequence of several painful conditions but can also favor pain chronicization when preexisting. Despite the apparent tight connection between clinical pain and mood/stress disorders, the exact physiological mechanisms remain unclear. This review aims to provide an overview of state-of-the-art research on the mechanisms of pain related to the pathophysiology of depression, anxiety, and stress disorders.