Cohen SP, Doshi TL, Dolomisiewicz E, Reece DE, Zhao Z, Anderson- White M, Kasuske A, Wang EJ, Hsu A, Davis SA, Yoo Y, Pasquina PF, Youn Moon J

Non-organic signs have gained traction for identifying patients who may benefit from psychotherapy, decreasing the risk of treatment failure. In conjunction with other clinical factors, these signs may refine patient selection, but their association with clinical outcomes has not been studied for neck pain. Seventy-eight patients with cervical radiculopathy who received epidural steroid injection (ESI) were followed to determine the effects non-organic signs and other factors have on treatment outcome. A positive outcome was a > 2-point decrease in average arm pain, coupled with a score of 5 on a 7-point patient global impression of change scale. Nine tests in 5 categories (abnormal tenderness, regional disturbances deviating from normal anatomy, overreaction, discrepancies in exam findings with distraction, and pain during sham stimulation) were modified from previous studies and standardized. Other variables examined for their association with non-organic signs and outcomes included measures of disease burden, psychopathology, co-existing pain conditions, sleep dysfunction, imaging, and somatization.

Cohen, S. P., Doshi, T. L., Dolomisiewicz, E., Reece, D. E., Zhao, Z., Anderson-Whitle, M., Kasuke, A., Wang, E. J., Hsu, A., Davis, S. A., Yoo, Y., Pasquina, P. F., & Youn Moon, J. (2022). What is the Incidence of Subsequent Adjacent Joint Injury After Patellofemoral Pain? Mayo Clinical Proceedings, 98(6), 868-882. https://doi.org/10.1016/j.mayocp.2022.11.022

Knox N, Lee C, Moon J, Cohen S

The objective of this multicenter prospective study was to determine the prevalence and breakdown of pain symptoms among patients with coronavirus disease 2019 (COVID-19) infection admitted for non-pain symptoms and the association between the presence of pain and intensive care unit (ICU) admission and death. Data on the intensity and type of pain were collected on 169 patients with active severe acute respiratory syndrome coronavirus 2 infection at 2 teaching hospitals in the United States and Korea and on 8 patients with acute pain at another large teaching hospital between February 1, 2020, and June 15, 2020. Results showed that acute pain is common during active COVID-19 infection with the most common manifestations being headache, chest pain and spine pain. Individuals without pain were more likely to require intensive care and expire than those with pain. Reasons why pain may be associated with reduced mortality include that an intense systemic stimulus (eg, respiratory distress) might distract pain perception or that the catecholamine surge associated with severe respiratory distress might attenuate nociceptive signaling.

Knox N, Lee C, Moon JY, Cohen SP. (2021). Pain Manifestations of COVID-19 and Their Association with Mortality: A Multicenter Prospective Observational Study. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2020.12.014.