Department of Anesthesiology, Division of Pain Medicine, University of Florida Health at Jacksonville, Jacksonville, Florida.
Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida; Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, Florida.
J Pain. 2022 Jan;23(1):25-44. doi: 10.1016/j.jpain.2021.06.015. Epub 2021 Jul 17.
Disparities in the experience of chronic musculoskeletal pain in the United States stem from a confluence of a broad array of factors. Organized within the National Institute on Aging Health Disparity Research Framework, a literature review was completed to evaluate what is known and what is needed to move chronic musculoskeletal pain research forward specific to disproportionately affected populations. Peer-reviewed studies published in English, on human adults, from 2000 to 2019, and conducted in the United States were extracted from PubMed and Web of Science. Articles were reviewed for key words that focused on underrepresented ethnic/race groups with chronic musculoskeletal pain applying health factor terms identified in the NIAHealth Disparity Research Framework four levels of analysis: 1) environmental, 2) sociocultural, 3) behavioral, and 4) biological. A total of 52 articles met inclusion criteria. There were limited publications specific to underrepresented ethnic/race groups with chronic musculoskeletal pain across all levels with particular research gaps under sociocultural and biological categories. Current limitations in evidence may be supplemented by a foundation of findings specific to the broader topic of "chronic pain" which provides guidance for future investigations. Study designs including a focus on protective factors and multiple levels of analyses would be particularly meritorious. PERSPECTIVE: Chronic musculoskeletal pain unequally burdens underrepresented ethnic/race groups. In order to move research forward and to systematically investigate the complex array of factors contributing toward health disparities, an organized approach is necessary. Applying the NIA Health Disparities Research Framework, an overview of the current state of evidence specific to chronic musculoskeletal pain and underrepresented ethnic/race groups is provided with future directions identified.
美国慢性肌肉骨骼疼痛体验的差异源于一系列广泛因素的共同作用。在国家老龄化研究所健康差异研究框架内,进行了文献综述,以评估在针对不成比例受影响人群的慢性肌肉骨骼疼痛研究方面,已知的内容和需要进一步研究的内容。从 PubMed 和 Web of Science 中提取了 2000 年至 2019 年期间以英文发表、针对人类成年人、在美国进行的且与慢性肌肉骨骼疼痛相关的、经同行评审的研究。对重点关注慢性肌肉骨骼疼痛的代表性不足的族裔/种族群体的关键词进行了回顾,应用了 NIAHealthDisparityResearchFramework 中分析的四个层次的健康因素术语:1)环境,2)社会文化,3)行为和 4)生物学。共有 52 篇文章符合纳入标准。在所有层面上,针对慢性肌肉骨骼疼痛的代表性不足的族裔/种族群体的出版物都很有限,特别是在社会文化和生物类别下存在特定的研究空白。目前证据的局限性可以通过更广泛的“慢性疼痛”主题的具体研究结果来补充,这为未来的研究提供了指导。特别值得关注的是,研究设计应包括对保护因素和多层次分析的关注。观点:慢性肌肉骨骼疼痛对代表性不足的族裔/种族群体造成了不平等的负担。为了推动研究的发展,并系统地研究导致健康差异的一系列复杂因素,需要采取有组织的方法。应用 NIA 健康差异研究框架,本文提供了针对慢性肌肉骨骼疼痛和代表性不足的族裔/种族群体的当前证据状况概述,并确定了未来的研究方向。