Physical symptoms and signs and chronic pain
Physical symptoms and signs and chronic pain
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DOI：
10.1097/00002508-200112001-00008
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发表时间：
2001-12-01
影响因子：
2.9
通讯作者：
Hunter, J
中科院分区：
文献类型：
--
作者：
Hunter, J
目的：用来指示组织损伤的位置和程度以及最初疼痛严重程度的生理发现是否可以预测随后的疼痛和残疾的报告？方法：标准化的文献搜索确定了一项系统性综述和12项观察性研究(9项下腰痛、2项颈痛和I腕管综合征)，以提供关于这些问题的证据。结果：大多数研究是特定人群的。这些研究是对预测因素的有用研究，但它们的概括性有限。在一些研究中，在后续研究中排除和失去受试者也限制了推广。结论：这些研究提供了中等程度的证据(第2级)，即报告急性肌肉骨骼损伤的疼痛强度可以预测随后的疼痛报告。有有限的证据(3级)表明，损伤的位置和程度可以预测疼痛和功能活动不良的结果。有中等程度的证据(第二级)表明，身体症状和体征不能被认为是慢性疼痛残疾的个体预测因素，因为参与结果是衡量的。相反，在从亚急性疼痛残疾向慢性疼痛残疾的转变过程中，功能性残疾和心理痛苦比疼痛强度发挥着更重要的作用。
Objective: Do physical findings that are used to indicate location and extent of tissue damage and a measure of the severity of initial pain predict subsequent reports of pain and of disability?Methodology: A standardized literature search identified one systematic review and 12 observational studies (9 low back pain, 2 neck pain, and I carpal tunnel syndrome) to provide evidence about these questions.Results: Most studies were of specific populations. These studies were useful studies of predictors, but they have limited generalizability. Exclusions and loss of subjects at follow-up in some studies also limited generalizability. Conclusions were made cautiously, because some factors with statistical correlations with chronic pain were not plausible predictors.Conclusions: The studies provide moderate evidence (level 2) that reports of the intensity of pain in acute musculoskeletal injury predict subsequent reports of pain. There is limited evidence (level 3) that the location and extent of injury predict reports of pain and poor functional activity outcomes. There is moderate evidence (level 2) that physical symptoms and signs cannot be considered individual predictors of chronic pain disability as measured by participation outcomes. Instead, in the transition from subacute to chronic pain disability, functional disability and psychological distress play a more important role than pain intensity.