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Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury

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Title: Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury
Author: Rosenbloom, Brittany N
Khan, Sobia
McCartney, Colin JL
Katz, Joel
Abstract: Background: Persistent pain and psychological distress are common after traumatic musculoskeletal injury (TMsI). Individuals sustaining a TMsI are often young, do not recover quickly, and place a large economic burden on society.
Objectives: The aim of this systematic review is to determine (1) the incidence of persistent pain following TMsI, (2) the characteristics of pain, characterized by injury severity and type, and (3) risk and protective factors associated with persistent pain following TMsI.
Methods: A systematic search of electronic databases (MEDLINE®, PubMed®, Embase, and PsycINFO®) was conducted for prospective, interventional, or noninterventional studies measuring the incidence of pain associated with TMsI.
Results: The search revealed 4388 studies. Eleven studies examined persistent pain and met inclusion criteria. Pain was assessed using a validated measure of pain intensity or pain presence in six studies. Persistent pain was reported by all studies at variable time points up to 84 months postinjury, with wide variation among studies in pain intensity (ie, from mild to very severe) and pain incidence at each time point. The incidence of pain decreased over time within each study. Two studies found significant relationships between injury severity and persistent pain. Frequently cited predictive factors for persistent pain included: symptoms of anxiety and depression, patient perception that the injury was attributable to external sources (ie, they were not at fault), cognitive avoidance of distressing thoughts, alcohol consumption prior to trauma, lower educational status, being injured at work, eligibility for compensation, pain at initial assessment, and older age.
Conclusion and implications: The evidence from the eleven studies included in this review indicates that persistent pain is prevalent up to 84 months following traumatic injury. Further research is needed to better evaluate persistent pain and other long-term posttraumatic outcomes.
Sponsor: Joel Katz is supported by a Canadian Research Chair in Health Psychology at York University.
Subject: persistent pain, psychological outcomes, traumatic injury, musculoskeletal, systematic review, pain intensity, injury severity, risk and protective factors
Type: Article
Rights: Original publication in: Journal of Pain Research, Dove Medical Press.
http://www.dovepress.com/systematic-review-of-persistent-pain-and-psychological-outcomes-follow-peer-reviewed-article-JPR
http://www.dovepress.com/journal-of-pain-research-journal
http://www.dovepress.com/
URI: http://hdl.handle.net/10315/26490
Published: Dove Medical Press Ltd.
Citation: Journal of Pain Research 2013:6 39–51
ISSN: 1178-7090
Date: 09/01/2013

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