Epidemiological surveys have recently revealed a high prevalence of chronic musculoskeletal pain in Japan;however, 30% of the patients in the survey were not satisfied with their pain treatment. This indicates that st...Epidemiological surveys have recently revealed a high prevalence of chronic musculoskeletal pain in Japan;however, 30% of the patients in the survey were not satisfied with their pain treatment. This indicates that standard strategies in the management of chronic pain are poorly shared among physicians in Japan. Herein we report a case of a patient with intractable chronic pain who is a skilled orthopaedic physician. A 43-year-old man who was a skilled orthopaedic surgeon presented at our center complaining of severe buttock pain especially around the right hip region for more than three years. At begging of pain onset, he was diagnosed with femoacetabular impingement syndrome (FAI) with labral tear. Despite biophysical interventions including twice surgeries and alternative conservative treatment, his pain persisted, and he occasionally had to take a day off work due to the severe pain. Therefore we had to evaluate his pathological condition using a multidimensional approach based on a biopsychosocial model. We had provided him with cognitive behavioral therapy (CBT) approach, and simultaneously suggestion for short leaving from work. Three months after the start of CBT training, his disabilities had begun to improve. About six months later, he could continue to do his work. Finally, 19 months have passed since we started implementing the CBT approach;he has regained both his previous work-life balance and his health, although the pain has not completely subsided. In conclusion, we think it is important for physicians treating chronic pain to learn the management strategies for chronic pain and to re-consider their management policy when conventional biomedical interventions were not succeeded, even in cases where medication and surgical intervention are warranted.展开更多
AIM To investigate the correlations between clinical outcomes and biopsychological variables in female patients with knee osteoarthritis(OA).METHODS Seventy-seven patients with symptomatic knee OA were enrolled in thi...AIM To investigate the correlations between clinical outcomes and biopsychological variables in female patients with knee osteoarthritis(OA).METHODS Seventy-seven patients with symptomatic knee OA were enrolled in this study.We investigated the age,body mass index(BMI),pain catastrophizing scale(PCS)and radiographic severity of bilateral knees using a Kellgren-Lawrence(K-L)grading system of the subjects.Subsequently,a multiple linear regression was conducted to determine which variables best correlated with main outcomes of knee OA,which were pain severity,moving capacity by measuring timed-up-and-go test and Japanese Knee Osteoarthritis Measure(JKOM).RESULTS We found that the significant contributor to pain severity was PCS(β=0.555)and BMI(β=0.239),to moving capacity was K-L grade(β=0.520)and to PCS(β=0.313),and to a JKOM score was PCS(β=0.485)and K-L grade(β=0.421),respectively.CONCLUSION The results suggest that pain catastrophizing as well as biological factors were associated with clinical outcomes in female patients with knee OA,irrespective of radiographic severity.展开更多
文摘Epidemiological surveys have recently revealed a high prevalence of chronic musculoskeletal pain in Japan;however, 30% of the patients in the survey were not satisfied with their pain treatment. This indicates that standard strategies in the management of chronic pain are poorly shared among physicians in Japan. Herein we report a case of a patient with intractable chronic pain who is a skilled orthopaedic physician. A 43-year-old man who was a skilled orthopaedic surgeon presented at our center complaining of severe buttock pain especially around the right hip region for more than three years. At begging of pain onset, he was diagnosed with femoacetabular impingement syndrome (FAI) with labral tear. Despite biophysical interventions including twice surgeries and alternative conservative treatment, his pain persisted, and he occasionally had to take a day off work due to the severe pain. Therefore we had to evaluate his pathological condition using a multidimensional approach based on a biopsychosocial model. We had provided him with cognitive behavioral therapy (CBT) approach, and simultaneously suggestion for short leaving from work. Three months after the start of CBT training, his disabilities had begun to improve. About six months later, he could continue to do his work. Finally, 19 months have passed since we started implementing the CBT approach;he has regained both his previous work-life balance and his health, although the pain has not completely subsided. In conclusion, we think it is important for physicians treating chronic pain to learn the management strategies for chronic pain and to re-consider their management policy when conventional biomedical interventions were not succeeded, even in cases where medication and surgical intervention are warranted.
文摘AIM To investigate the correlations between clinical outcomes and biopsychological variables in female patients with knee osteoarthritis(OA).METHODS Seventy-seven patients with symptomatic knee OA were enrolled in this study.We investigated the age,body mass index(BMI),pain catastrophizing scale(PCS)and radiographic severity of bilateral knees using a Kellgren-Lawrence(K-L)grading system of the subjects.Subsequently,a multiple linear regression was conducted to determine which variables best correlated with main outcomes of knee OA,which were pain severity,moving capacity by measuring timed-up-and-go test and Japanese Knee Osteoarthritis Measure(JKOM).RESULTS We found that the significant contributor to pain severity was PCS(β=0.555)and BMI(β=0.239),to moving capacity was K-L grade(β=0.520)and to PCS(β=0.313),and to a JKOM score was PCS(β=0.485)and K-L grade(β=0.421),respectively.CONCLUSION The results suggest that pain catastrophizing as well as biological factors were associated with clinical outcomes in female patients with knee OA,irrespective of radiographic severity.
