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APS Press Room

News from The Journal of Pain • July 2010
Published by the American Pain Society

 
For immediate release Contact: Chuck Weber
(847) 705-1802

Study Probes Obesity and Chronic Pain Links

GLENVIEW, IL, July 19, 2010 – Though it is well known obese individuals have a high incidence of persistent pain problems, a new study in The Journal of Pain, published by the American Pain Society, reports that comorbid obesity and pain also are linked to family history and mood disorders.

Chronic pain and obesity are rampant in the U.S. and responsible for a significant percentage of physician visits and health care expenditures. Costs related to obesity are estimated at $118 billion a year and for chronic pain the estimate is $70 billion in direct health care expenses and lost productivity. Several studies have shown that overweight persons are at greater risk for chronic pain mainly from increased pressure that excessive weight places on the joints. As a result, the most common pain disorders related to weight are low back pain and osteoarthritis.

A research team from the University of California San Diego, University of Washington and Veterans’ Affairs San Diego Healthcare System explored how family history and psychological factors influence the relationship between obesity and chronic pain. They examined data from a large community-based sample of twins (University of Washington Twin Registry) to probe the relationships between specific pain diagnoses and symptoms and obesity, depression, and familial factors. For the study, 3,471 individual twins were analyzed.

Data from the research showed that overweight or obese twins were more likely to report physician-diagnosed low back pain, tension or migraine headaches, fibromyalgia, and abdominal and widespread pain. Further, it was determined that depression and family history play a significant role linking high body mass index (BMI) and pain symptoms. The authors noted their results are consistent with findings from a previous twins study showing a connection between low back pain and obesity.

Regarding depression, the authors reported that behavioral factors are implicated in the maintenance of obesity and pain. Depression-related inactivity and a sedentary lifestyle can lead to obesity and contribute to the transition from acute pain to chronic pain. Also, depressed persons may withdraw from physical activities, eventually put on excess weight, and develop low back pain or other conditions.

Study Shows Treatment by Non-white Physicians Results in Better Pain Control with Less Analgesia

GLENVIEW, IL, July 19, 2010 – Research has shown that patients from ethnic minority groups receive less analgesic-based pain treatment in emergency departments than whites, however, a study published in The Journal of Pain reports that nonwhite physicians achieve better pain control using less analgesia.

Previous studies on emergency department pain care for minorities have not addressed the effectiveness of pain treatment in relation to patient and provider race. Researchers from University of South Alabama, Beth Israel Medical Center (NY) and Yale University hypothesized that patient and provider race and their concordance would have a significant influence on patient outcomes.

For the study 776 emergency department patients were analyzed. Eighty-five percent were treated by white clinicians. Results showed that nonwhite physicians were more likely to achieve clinically relevant reductions in pain intensity than white physicians, but ethnic concordance of physicians and patients did not predict outcomes.

The data showed that nonwhite physicians ordered analgesics at similar rates as white physicians but prescribed opioids at lower rates. However, nonwhite physicians had better success in reducing pain intensity, which the authors believe may be attributable to patient-physician interaction factors. Previous studies have reported that provider behavior variables like question asking, participatory style and overall personal warmth may contribute to successful pain treatment outcomes in the emergency department by nonwhite physicians.

Limitations of the research noted by the authors are the low number of black, Asian and Hispanic physicians studied and lack of information on other factors influencing treatment success, such as physician age, training, experience and communication skills.

Sources:

Chronic Pain, Overweight and Obesity: Findings from a Community-based Twin Registry;Lisa Johnson Wright, Ellen Schur, Carolyn Noonan, Sandra Ahumada, Dedra Buchwald and Niloofar Afari, University of California San Diego, University of Washington and Veterans Affairs San Diego Healthcare System

Physician Race/Ethnicity Predicts Successful Emergency Department Analgesia;Alan Heins, Peter Homel, Basmah Safdar and Knox Todd; University of South Alabama, Beth Israel Medical Center (NY) and Yale University.