The identification of certain clinical characteristics that may interfere with the clinical condition and treatment of patients with musculoskeletal pain

Abstract

Introduction: Studying musculoskeletal pain is important because it addresses a common and impactful health issue affecting individuals, healthcare systems, and society. New studies can improve the diagnosis and treatment of this condition. Objective: The present thesis aimed to identify specific clinical characteristics that may interfere with the clinical presentation and treatment of patients with musculoskeletal pain. Methods: This thesis comprised 06 (six) articles with different study designs for each objective. Three (03) cross-sectional articles investigated potential clinical characteristics that can interferes with the clinical feature of patients with musculoskeletal pain. One article evaluated the correlation between the widespread pain index and the painMAP software to assess areas of pain in patients with widespread pain. One letter to the editor advices physiotherapists on pain treatment after the 2019 coronavirus (COVID-19). One systematic review aimed to identify the neurophysiological effects of neural mobilisation in patients with neuropathic pain phenotype. Results: The subtopic 2.2.1 shows that patients with inadequate health literacy had higher levels of pain intensity and kinesiophobia compared to other groups. The subtopic 2.2.2 reveals that patients with fibromyalgia higher levels of pain intensity, presence of neuropathic symptoms, and presence of central sensitisation symptoms, compared to patients with widespread pain. The same population was investigated in subtopic 2.2.3 which concludes a weak positive correlation between the widespread pain index and the painMAP software for assessing pain areas in patients with widespread pain. The results of subtopic 2.2.4 revealed that the model trained using the algorithm (XGBoost) has the potential to predict the effectiveness of conditioned pain modulation in patients with musculoskeletal pain. The letter to the editor presented in subtopic 2.2.5 advices physiotherapists in providing pain treatment after an episode of 2019 coronavirus (COVID-19). The systematic review in the topic 3.1 shows an improvement in the cross-sectional area of patients with peripheral neuropathic pain after neural mobilisation, according to very low-quality evidence. Furthermore, very low to moderate-quality evidence suggests that neural mobilisation was superior to control in improving motor and sensory conduction velocity in patients with peripheral neuropathic pain. Conclusion: This thesis presents a series of important findings related to musculoskeletal pain, including the influence of health literacy, pain characteristics in patients with fibromyalgia, the correlation between widespread pain index and painMAP software, the effectiveness of XGBoost in predicting conditioned pain modulation, guidance for physiotherapeutic treatment after COVID-19, and the neural mobilisation was able to improve the cross-sectional area (evidence of very low quality) and motor and sensory conduction velocities (evidence of very low to moderate quality) in patients with peripheral neuropathic pain. These results highlight the complexity of musculoskeletal pain and offer valuable insights for healthcare professionals and researchers, contributing to a better understanding and management of this clinical condition.