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      The Case for Comorbid Myofascial Pain—A Qualitative Review

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          Abstract

          Myofascial pain syndrome is widely considered to be among the most prevalent pain conditions, both in the community and in specialized pain clinics. While myofascial pain often arises in otherwise healthy individuals, evidence is mounting that its prevalence may be even higher in individuals with various comorbidities. Comorbid myofascial pain has been observed in a wide variety of medical conditions, including malignant tumors, osteoarthritis, neurological conditions, and mental health conditions. Here, we review the evidence of comorbid myofascial pain and discuss the diagnostic and therapeutic implications of its recognition.

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          Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors.

          C. M. Morin, M. Leblanc, M. Daley … (2006)
          To estimate the prevalence of insomnia symptoms and syndrome in the general population, describe the types of self-help treatments and consultations initiated for insomnia, and examine help-seeking determinants. A randomly selected sample of 2001 French-speaking adults from the province of Quebec (Canada) responded to a telephone survey about sleep, insomnia, and its treatments. Of the total sample, 25.3% were dissatisfied with their sleep, 29.9% reported insomnia symptoms, and 9.5% met criteria for an insomnia syndrome. Thirteen percent of the respondents had consulted a healthcare provider specifically for insomnia in their lifetime, with general practitioners being the most frequently consulted. Daytime fatigue (48%), psychological distress (40%), and physical discomfort (22%) were the main determinants prompting individuals with insomnia to seek treatment. Of the total sample, 15% had used at least once herbal/dietary products to facilitate sleep and 11% had used prescribed sleep medications in the year preceding the survey. Other self-help strategies employed to facilitate sleep included reading, listening to music, and relaxation. These findings confirm the high prevalence of insomnia in the general population. While few insomnia sufferers seek professional consultations, many individuals initiate self-help treatments, particularly when daytime impairments such as fatigue become more noticeable. Improved knowledge of the determinants of help-seeking behaviors could guide the development of effective public health prevention and intervention programs to promote healthy sleep.
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            Comorbidity of chronic insomnia with medical problems.

            Daniel Taylor, Laurel Mallory, Kenneth L Lichstein … (2007)
            Determine the comorbidity of insomnia with medical problems. Cross-sectional and retrospective. Community-based population of 772 men and women, aged 20 to 98 years old. Self-report measures of sleep, health, depression, and anxiety. People with chronic insomnia reported more of the following than did people without insomnia: heart disease (21.9% vs 9.5%), high blood pressure (43.1% vs 18.7%), neurologic disease (7.3% vs 1.2%), breathing problems (24.8% vs 5.7%), urinary problems (19.7% vs 9.5%), chronic pain (50.4% vs 18.2%), and gastrointestinal problems (33.6% vs 9.2%). Conversely, people with the following medical problems reported more chronic insomnia than did those without those medical problems: heart disease (44.1% vs 22.8%), cancer (41.4% vs 24.6%), high blood pressure (44.0% vs 19.3%), neurologic disease (66.7% vs 24.3%), breathing problems (59.6% vs 21.4%), urinary problems (41.5% vs 23.3%), chronic pain (48.6% vs 17.2%), and gastrointestinal problems (55.4% vs 20.0%). When all medical problems were considered together, only patients with high blood pressure, breathing problems, urinary problems, chronic pain, and gastrointestinal problems continued to have statistically higher levels of insomnia than those without these medical disorders. This study demonstrates significant overlap between insomnia and multiple medical problems. Some research has shown it is possible to treat insomnia that is comorbid with select psychiatric (depression) and medical (eg, pain and cancer) disorders, which in turn increases the quality of life and functioning of these patients. The efficacy of treating insomnia in many of the above comorbid disorders has not been tested, indicating a need for future treatment research.
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              Sleep deprivation and pain perception.

              Jürgen-Christian Krieg, Stefan Lautenbacher, Bernd Kundermann (2006)
              Chronically painful conditions are frequently associated with sleep disturbances, i.e. changes in sleep continuity and sleep architecture as well as increased sleepiness during daytime. A new hypothesis, which has attracted more and more attention, is that disturbances of sleep cause or modulate acute and chronic pain. Since it is well-known that pain disturbs sleep the relationship between the two has since recently been seen as reciprocal. To fathom the causal direction from sleep to pain we have reviewed experimental human and animal studies on the effects of sleep deprivation on pain processing. According to the majority of the studies, sleep deprivation produces hyperalgesic changes. Furthermore, sleep deprivation can interfere with analgesic treatments involving opioidergic and serotoninergic mechanisms of action. The still existing inconsistency of the human data and the exclusive focus on REM sleep deprivation in animals so far do not allow us to draw firm conclusions as to whether the hyperalgesic effects are due to the deprivation of specific sleep stages or whether they result from a generalized disruption of sleep continuity.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Environ Res Public Health
                Journal ID (iso-abbrev): Int J Environ Res Public Health
                Journal ID (publisher-id): ijerph
                Title: International Journal of Environmental Research and Public Health
                Publisher: MDPI
                ISSN (Print): 1661-7827
                ISSN (Electronic): 1660-4601
                Publication date (Electronic): 17 July 2020
                Publication date (Print): July 2020
                Volume: 17
                Issue: 14
                Electronic Location Identifier: 5188
                Affiliations
                Institute for Pain Medicine, Rambam Health Care Campus, Haifa, Israel Rappaport School of Medicine, Technion Institute of Technology, Haifa 31096, Israel; a_minerbi@ 123456rambam.health.gov.il
                Author notes
                [* ]Correspondence: s_vulfsons@ 123456rambam.health.gov.il ; Tel.: +972-47772234; Fax: +972-47773505
                Author information
                https://orcid.org/0000-0003-4889-0105
                Article
                Publisher ID: ijerph-17-05188
                DOI: 10.3390/ijerph17145188
                PMC ID: 7400256
                PubMed ID: 32709141
                SO-VID: 3f69a292-7651-49d1-86f3-d57ece578664
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 02 May 2020
                Date accepted : 08 July 2020
                Categories
                Subject: Review

                ScienceOpen disciplines: Public health
                Keywords: myofascial pain syndrome,comorbid pain,chronic pain,secondary pain
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: myofascial pain syndrome, comorbid pain, chronic pain, secondary pain

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