ISSN: 2161-1149 (Printed)
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Victor Domenech-Garcia, Gorka Ortego, Jorge Hugo Villafane, Pedro Berjano, Lucia Bertozzi, Pablo Bellosta and Pablo Herrero VÃ?Âctor Domenech Garcia
San Jorge University, Spain
Posters & Accepted Abstracts: Rheumatology (Sunnyvale)
Purpose: Systematically review and synthesis the research evidence linking chronic pain and stress and anxiety related to the upper quadrant in adults. Subjects & Methods: Data were obtained from Pub-med database from their inception to July 2015. Two authors independently conducted the searches, extracted data and completed methodological quality assessments. Articles were included if they measured the psychological stress or anxiety related to upper quadrant in adults with chronic pain, or explored the association between the two. The methodological quality of the cohort and case�control studies was evaluated using the Newcastle-Ottawa scale, whilst the quality of the RCT was evaluated using Pedro scale. Results: Twenty-three studies involving 17.809 participants met the inclusion criteria. Four studies, including 5 pair-wise comparisons, were included in the meta-analysis: Three were cohort studies and 1 was cross-sectional study. The meta-analysis outcome was the relationship between chronic pain and psychological stress. The estimate odds ratio for all studies combining was 2.33 (95% CI, 1.04-2.33; p=0.039). A high heterogeneity of findings appeared (Q =28.94, I2= 86% p=0.00). Egger t test was no significant and negative. Conclusion: This study shows that there is a relationship between stress and chronic pain in the upper quadrant. Despite this, we cannot support that stress is a risk factor for chronic pain due to the low quality of the results according Grading of Recommendations Assessment, Development and Evaluation (GRADE). It was not possible to make a quantitative analysis comparing the relationship between anxiety and chronic pain in the upper quadrant.
Email: saurabh.malviya@medanta.org