musculoskeletal pain

肌肉骨骼疼痛
  • 文章类型: Journal Article
    以前,睡眠不足与受伤风险增加和表现下降有关。目前尚不清楚睡眠障碍是否与肌肉骨骼症状有关,这可能是严重伤害和影响性能的预测因素。因此,目的是评估精英青少年羽毛球运动员的睡眠行为及其与肌肉骨骼症状的关系。2018年,世界青少年羽毛球锦标赛的运动员完成了运动员睡眠行为问卷和世界奥林匹克协会肌肉骨骼健康问卷的修订版。参与者以不良或中度/良好的睡眠行为为自变量。肌肉骨骼症状是主要结果,并使用是/否问题进行分类。相关的肌肉骨骼症状被定义为疼痛高于30毫米数字评定量表疼痛评分或每天超过30分钟的关节僵硬。使用卡方分析和逻辑回归进行分组比较,以调整年龄,性别,种族,以前的伤害,训练负荷,和休息的日子。在153名参与者中,28%的人报告睡眠得分不佳。关于性别等人口统计学变量,睡眠评分差和中度/良好之间没有差异,年龄,种族,以前的伤害,训练负荷,和休息的日子。有27%的人目前有肌肉骨骼症状,但在睡眠评分差和中度/良好之间没有差异(P=0.376)。这产生了1.23的调整比值比(95%置信区间0.52;2.90)。28%的参与者报告睡眠行为不良。27%的人经历了当前的肌肉骨骼症状。当将睡眠行为不良的运动员与睡眠行为中等/良好的运动员进行比较时,我们发现报告的肌肉骨骼症状没有统计学差异。
    Sleep inadequacy has previously been associated with increased risk of injury and reduced performance. It is unclear if sleep disorders are associated with musculoskeletal symptoms, which may be a predictor of serious injury and affect performance. The aim was therefore to assess sleep behavior in elite junior badminton players and its association to musculoskeletal symptoms. In 2018, players at the World Junior Badminton Championship completed the Athlete Sleep Behavior Questionnaire and a modified version of the World Olympic Association Musculoskeletal Health Questionnaire. Participants were categorized with poor or moderate/good sleep behavior as the independent variable. Musculoskeletal symptoms were the primary outcome and was categorized using yes/no questions. Relevant musculoskeletal symptoms were defined as pain higher than 30 mm Numeric Rating Scale pain score or more than 30 minutes of joint stiffness a day. Group comparison was performed using chi-square analysis and logistic regression for primary outcome adjusted for age, sex, ethnicity, previous injury, training load, and resting days. Of the 153 participants, 28% reported poor sleep scores. There was no difference between poor and moderate/good sleep score concerning demographic variables such as sex, age, ethnicity, previous injury, training load, and resting days. There were 27% with current musculoskeletal symptoms but with no difference in groups between poor and moderate/good sleep score (P = .376). This yielded an adjusted odds ratio of 1.23 (95% confidence intervals 0.52; 2.90). Twenty-eight percent of the participants reported poor sleep behavior. Twenty-seven percent experienced current musculoskeletal symptoms. We found no statistical differences in reported musculoskeletal symptoms when comparing athletes with poor sleep behavior to athletes with moderate/good sleep behavior.
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  • 文章类型: Journal Article
    目的:开发和验证未来缺勤风险和出勤水平的预测模型,在寻求肌肉骨骼疾病(MSD)的初级医疗保健的成年人中。
    方法:来自英格兰西米德兰兹郡/西北地区的六项研究,纳入招募向MSD咨询初级保健的成年人进行模型开发和内部-外部交叉验证(IECV).主要结果是咨询后6个月内的任何工作缺勤。次要结果包括6个月的出勤和12个月的缺勤。包括10个候选预测因子:年龄;性别;多部位疼痛;基线疼痛评分;疼痛持续时间;工作类型;焦虑/抑郁;合并症;前6个月缺席;和基线表现。
    结果:对于6个月的缺勤模型,在五项研究中,有2179名参与者(215名缺席)。校准很有希望,虽然不同的研究,IECV的合并校准斜率为0.93(95%CI:0.41-1.46)。平均而言,该模型很好地区分了6个月内缺勤的人,和没有(IECV汇集的C统计量0.76,95%CI:0.66-0.86)。6个月的出勤模式,虽然平均校准很好,在预测准确性方面表现出一些个体水平的变化,并且由于模型开发的可用尺寸较小,因此12个月的缺席模型校准不佳。
    结论:开发的模型以合理的准确性预测了6个月的缺勤和出勤,平均而言,在成人咨询MSD。预测12个月缺席的模型校准不佳,尚未准备好在实践中使用。这些信息可能支持在咨询后6个月内对缺勤或出勤风险较高的人进行共同决策和针对职业健康干预。在推荐使用模型或全面评估其对患者的影响之前,需要进一步的外部验证。
    OBJECTIVE: To develop and validate prediction models for the risk of future work absence and level of presenteeism, in adults seeking primary healthcare with musculoskeletal disorders (MSD).
    METHODS: Six studies from the West-Midlands/Northwest regions of England, recruiting adults consulting primary care with MSD were included for model development and internal-external cross-validation (IECV). The primary outcome was any work absence within 6 months of their consultation. Secondary outcomes included 6-month presenteeism and 12-month work absence. Ten candidate predictors were included: age; sex; multisite pain; baseline pain score; pain duration; job type; anxiety/depression; comorbidities; absence in the previous 6 months; and baseline presenteeism.
    RESULTS: For the 6-month absence model, 2179 participants (215 absences) were available across five studies. Calibration was promising, although varied across studies, with a pooled calibration slope of 0.93 (95% CI: 0.41-1.46) on IECV. On average, the model discriminated well between those with work absence within 6 months, and those without (IECV-pooled C-statistic 0.76, 95% CI: 0.66-0.86). The 6-month presenteeism model, while well calibrated on average, showed some individual-level variation in predictive accuracy, and the 12-month absence model was poorly calibrated due to the small available size for model development.
    CONCLUSIONS: The developed models predict 6-month work absence and presenteeism with reasonable accuracy, on average, in adults consulting with MSD. The model to predict 12-month absence was poorly calibrated and is not yet ready for use in practice. This information may support shared decision-making and targeting occupational health interventions at those with a higher risk of absence or presenteeism in the 6 months following consultation. Further external validation is needed before the models\' use can be recommended or their impact on patients can be fully assessed.
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  • 文章类型: Journal Article
    目的:使用临床疼痛测量工具来调查和比较有子宫内膜异位症和无子宫内膜异位症的女性的盆腔腰外疾病的患病率。
    方法:与子宫内膜异位症相关的慢性盆腔疼痛(CPP)有不同的起源,包括肌肉骨骼因素.从理论上讲,骨盆区域的肌肉骨骼功能障碍是由持续的肌肉收缩引起的,由改变的内脏刺激和采取止痛姿势引发,对肌肉造成二次损伤,韧带,和关节。CPP显著影响生活质量,关系,性,和心理健康。然而,关于子宫内膜异位症和CPP的肌肉骨骼影响的数据有限。该研究于2017年8月至2021年1月在MaternidadeEscolaAssisChateaubriand进行了病例对照研究。评估71名妇女:子宫内膜异位症组(EG)41名,对照组(CG)30名。数据收集包括社会人口统计问卷,肌肉骨骼理疗评估,疼痛映射,压力疼痛阈值,运动恐惧症,残疾测量。使用SpearmanRho检验进行统计分析以确定相关性。
    结果:参与者的平均年龄为31岁。EG在腰骨盆触发点的疼痛阈值变化低于CG(P<0.05)。观察到两组之间的肌肉柔韧性差异显着;EG的柔韧性降低(P<0.05)。最常见的疼痛区域是EG的胃下(48.78%)和CG的左腰椎(30%)。EG具有较高的运动恐惧症值(P=.009)。在CG的腰椎骨盆区域观察到的运动恐惧症与压力阈值之间的关联较弱。
    结论:患有子宫内膜异位症和CPP的女性表现出更高的肌肉骨骼疾病患病率,较低的疼痛阈值,腰骨盆肌活动范围减少,运动恐惧症得分较高,与健康女性相比,腰背痛的残疾指数增加。
    OBJECTIVE: Use clinical pain measurement tools to investigate and compare the prevalence of pelvic loin disoders in women with and without endometriosis.
    METHODS: Chronic pelvic pain (CPP) associated with endometriosis has diverse origins, including musculoskeletal factors. Musculoskeletal dysfunction in the pelvic region is theorized to result from sustained muscular contraction, triggered by altered visceral stimuli and adoption of antalgic postures, causing secondary damage to muscles, ligaments, and joints. CPP significantly impacts quality of life, relationships, sexuality, and mental health. However, limited data exists on musculoskeletal impacts of endometriosis and CPP. It was made a case-control study at Maternidade Escola Assis Chateaubriand from August 2017 to January 2021. Evaluated 71 women: 41 in endometriosis group (EG) and 30 in control group (CG). Data collection included sociodemographic questionnaires, musculoskeletal physiotherapeutic evaluations, pain mapping, pressure pain thresholds, kinesiophobia, and disability measurements. Statistical analysis was performed using Spearman\'s Rho test to determine correlations.
    RESULTS: Mean age of participants was 31 years. EG exhibited lower pain threshold variations in lumbopelvic trigger points than CG (P < .05). Significant muscle flexibility differences between groups were observed; EG had reduced flexibility (P < .05). Most common pain areas were hypogastrium in EG (48.78 %) and left lumbar in CG (30 %). EG had higher kinesiophobia values (P = .009). There was a weak association between kinesiophobia-pressure threshold association observed in CG\'s lumbar pelvic region.
    CONCLUSIONS: Women with Endometriosis and CPP exhibit higher prevalence of musculoskeletal disorder, lower pain thresholds, decreased lumbopelvic muscle range of motion, higher kinesiophobia scores, and increased disability indices with low back pain compared to healthy women.
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  • 文章类型: Journal Article
    肌肉骨骼疾病在老年人中非常普遍,可能对他们的生活质量产生重大影响。肌肉骨骼健康是保持健康和独立的重要组成部分。需要采取积极主动的方法,护士实施健康饮食和体育锻炼等策略,以支持最佳健康。这篇文章认为肌肉骨骼健康的重要性,检查肌肉骨骼健康下降的风险因素,并探索可以改善结果和促进健康老龄化的方法。
    Musculoskeletal conditions are highly prevalent among older adults and can have a significant impact on their quality of life. Musculoskeletal health is an important component of maintaining well-being and independence. A proactive approach is required, with nurses implementing strategies such as healthy diets and physical exercise that will support optimal health. This article considers the importance of musculoskeletal health, examines the risk factors for a decline in musculoskeletal health, and explores approaches that can improve outcomes and promote healthy ageing.
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  • 文章类型: Journal Article
    肌肉骨骼(MSK)疾病包括影响骨骼的各种条件,肌肉,肌腱,韧带,和神经。全球估计有17.1亿人患有MSK疾病,导致残疾和生活质量下降。文献与肌肉骨骼疼痛和残疾仅由身体损伤引起的观念相矛盾;心理,行为,社会因素的贡献很大。这些方面影响疼痛感知和慢性损害发展。常见的干预措施-药物治疗,锻炼,手动和水疗,电热模式,行为和替代疗法-单独解决疼痛,但缺乏所需的全面回应。相比之下,多模式方法结合了针对个人需求的多种疗法。它确保了症状的持久缓解,防止复发,并改善功能。虽然证明有效,这种方法的临床实施仍然有限.这篇小型评论讨论了这一差距背后的原因,强调了多模式方法的重要性,并启发康复专业人士了解其管理慢性肌肉骨骼问题的潜力。
    Musculoskeletal (MSK) disorders encompass various conditions impacting bones, muscles, tendons, ligaments, and nerves. An estimated 1.71 billion individuals globally have MSK disorders, causing disability and reduced quality of life. Literature contradicts the notion that musculoskeletal pain and disability solely arise from physical impairments; psychological, behavioural, and social factors contribute significantly. These facets influence pain perception and chronic impairment development. Common interventions-medication, exercise, manual and hydrotherapy, electro-thermal modalities, behavioural and alternative therapies-address pain individually, yet lack the comprehensive response required. In contrast, a multimodal approach combines diverse therapies tailored to individual needs. It ensures lasting symptom relief, prevents recurrence, and improves function. Although proven effective, clinical implementation of this approach remains limited. This mini-review discusses the reasons behind this gap, underscores multimodal approach importance, and enlightens rehabilitation professionals on its potential for managing chronic musculoskeletal issues.
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  • 文章类型: Journal Article
    关节过度活动综合征,特别是与这种情况相关的慢性疼痛,包括HypermobileEhlers-Danlos综合征(hEDS)和高移动性频谱障碍(HSD),由于其多因素起源,目前存在诊断挑战,并且从生物力学和基因组分子的角度仍然知之甚少。最近的诊断指南区分了hEDS,HSD,良性关节过度活动,提供更客观的诊断框架。然而,错误的诊断和诊断不足持续存在,导致受影响个体的长途旅行。肌肉骨骼表现,慢性疼痛,自主神经失调,胃肠道症状说明了这些疾病的多因素影响,影响受影响个体的身体和情绪健康。红外热成像(IRT)成为一种有前途的联合评估工具,特别是在检测炎症过程中。热分布模式提供了对关节功能障碍的宝贵见解,尽管疼痛和炎症之间的直接相关性仍然具有挑战性。超动个体中神经病的患病率加剧了疼痛感知和热成像发现之间的不一致。进一步复杂的诊断和管理。尽管有潜力,IRT的临床整合面临挑战,相互矛盾的证据阻碍了它的采用。然而,研究表明健康和患病关节之间的客观温度差异,特别是在动态热成像下,表明其在临床实践中的潜在效用。未来的研究重点是完善诊断标准和阐明过度活动综合征的潜在机制,对于在这种复杂和多维的背景下提高诊断准确性和增强患者护理至关重要。
    Joint hypermobility syndromes, particularly chronic pain associated with this condition, including Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD), present diagnostic challenges due to their multifactorial origins and remain poorly understood from biomechanical and genomic-molecular perspectives. Recent diagnostic guidelines have differentiated hEDS, HSD, and benign joint hypermobility, providing a more objective diagnostic framework. However, incorrect diagnoses and underdiagnoses persist, leading to prolonged journeys for affected individuals. Musculoskeletal manifestations, chronic pain, dysautonomia, and gastrointestinal symptoms illustrate the multifactorial impact of these conditions, affecting both the physical and emotional well-being of affected individuals. Infrared thermography (IRT) emerges as a promising tool for joint assessment, especially in detecting inflammatory processes. Thermal distribution patterns offer valuable insights into joint dysfunctions, although the direct correlation between pain and inflammation remains challenging. The prevalence of neuropathies among hypermobile individuals accentuates the discordance between pain perception and thermographic findings, further complicating diagnosis and management. Despite its potential, the clinical integration of IRT faces challenges, with conflicting evidence hindering its adoption. However, studies demonstrate objective temperature disparities between healthy and diseased joints, especially under dynamic thermography, suggesting its potential utility in clinical practice. Future research focused on refining diagnostic criteria and elucidating the underlying mechanisms of hypermobility syndromes will be essential to improve diagnostic accuracy and enhance patient care in this complex and multidimensional context.
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  • 文章类型: Journal Article
    自2000年代以来,超声(US)在疼痛医学中的应用一直是一个快速增长的领域。肌肉骨骼注射,周围神经阻滞,在美国指导下的神经轴注射已被公认用于治疗慢性疼痛。尽管已经发表了许多关于美国指导疼痛程序的研究,需要有一个分类系统来评估哪个图像设备,美国或透视,在各种疼痛干预措施中,临床和技术上都更好。因此,本叙述性综述根据临床和技术结局介绍了美国指导疼痛手术的分类系统,并通过回顾以往的前瞻性随机比较试验,将美国指导疼痛手术分为4类.
    The application of ultrasound (US) in pain medicine has been a rapidly growing field since the 2000s. Musculoskeletal injections, peripheral nerve blocks, and neuraxial injections under US guidance have been acknowledged for managing chronic pain. Although many studies on US-guided pain procedures have been published, there needs to be a classification system to evaluate which image device, the US or fluoroscopy, is clinically and technically better in various pain interventions. Therefore, this narrative review introduces the classification system for the US-guided pain procedures according to their clinical and technical outcomes and designates US-guided pain procedures into one of the four categories by reviewing previous prospective randomized comparative trials.
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  • 文章类型: Journal Article
    下腰痛(LBP)是导致劳动力流失的常见公共卫生问题。
    本研究旨在评估土耳其东南部城市驾驶员之间的LBP状况及其影响因素。
    这项横断面问卷调查研究是在323名驾驶员中进行的。采用卡方检验和logistic回归分析。
    驾驶员的平均年龄为41.7±11.5岁(最小:19,最大:70),83.9%的人已婚,都是男人.在59.4%的驾驶员中发现了LBP。在社会经济地位较差的驾驶员中,这一比例明显更高,对自己的生活不满意,患有慢性疾病,身体不活跃,有睡眠障碍,暴露在恶劣的路况下,长时间的振动,高身体-心理工作量,有LBP家族史(p<0.05)。年龄之间没有显著关联,教育水平,BMI与LBP(p>0.05)。
    土耳其对这一主题的研究有限。进一步的研究可以提高对这个问题的认识,并制定教育计划。
    UNASSIGNED: Low back pain (LBP) is a common public health problem resulting in workforce loss.
    UNASSIGNED: This study aims to evaluate the LBP status and its affecting factors among drivers in a city in southeast Turkey.
    UNASSIGNED: This cross-sectional questionnaire survey study was conducted among 323 drivers. The chi-square test and logistic regression analysis were used to analyze the data.
    UNASSIGNED: The mean age of the drivers was 41.7±11.5 years (min: 19, max: 70), and 83.9% were married, and all were men. LBP was found in 59.4% of drivers. It was significantly higher in drivers with poor socioeconomic status, dissatisfied with their life, having a chronic illness, physically inactive, having sleep disorders, exposed to bad road conditions, prolonged vibration, high physical- psychological workload, and a family history of LBP (p <  0.05). There was no significant association between age, education level, and BMI with LBP (p >  0.05).
    UNASSIGNED: There is limited study on this subject in Turkey. Further studies can raise awareness about this issue and create an educational plan.
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  • 文章类型: Journal Article
    简介残疾医生很可能会面临重大的生活危机和来自不可预见的环境的痛苦情绪,这些情绪威胁着他们的身体健康。我们旨在审查残疾外科医生,以确定可能导致外科医生疼痛和残疾的工作相关风险因素。遭受无法预测的灾难导致残疾的外科医生也是我们关注的焦点。方法我们进行了为期10年的文献综述。关于外科医生身体残疾的引文从灰色文献中得到补充,并附有残疾外科医生的评论。定量引用是通过MERSQI评分评估的质量。对于定性研究部分,通过Cullberg的危机阶段(CCP)对严重创伤的外科医生进行评估,并从Tedeschi和Calhoun的创伤后成长视角(PTG)进行分析.结果共研究了PubMed的3593篇引文,10篇引文符合纳入标准,共有11591名参与者.我们包括6名遭受高度创伤事件的外科医生,这使他们的医疗生涯复杂化。我们的定量引用MERSQI平均得分为11.73(SD.79)。我们发现我们的定量结果落在证据二级(中等质量=11.26-12.00分)上,与工作有关的疼痛,包括肌肉骨骼疼痛和职业伤害,可能导致身体残疾。意外受伤的外科医生经历了CCP的四个阶段,并达到了PTG阶段。结论外科工作人员有很高的工作相关的肌肉骨骼疾病的风险,这可以发展为慢性疼痛和中断外科医生的职业生涯。残疾外科医生在职业生涯中面临严重障碍。机构和医疗保健系统必须紧急为残疾外科医生制定支持策略。
    UNASSIGNED: Doctors with disability are likely to face major life crises, challenges and distressing emotions from unforeseen circumstances that threaten their physical well-being. We aimed to identify the existence of work-related pain and discomfort that may cause surgeon\'s disability. Surgeons who were struck with unpredictable disasters leading to disabilities were also reviewed.
    UNASSIGNED: We conducted a 10-year literature review. In addition, citations about surgeons\' physical disabilities were complemented with commentaries about disabled surgeons from gray literature. The quantitative citations were quality assessed by MERSQI scores and evidence graded according to GRADE. For the qualitative study part, the severely traumatized surgeons were analysed by means of Cullberg\'s crisis phases (CCP) and analysed from Tedeschi and Calhoun\'s post-traumatic growth perspective (PTG).
    UNASSIGNED: Altogether 3593 citations from PubMed were studied, and 10 citations met inclusion criteria with a total of 11591 participants. We included 6 surgeons subjected to highly traumatic events complicating their medical career. Our quantitative citations\' mean MERSQI score was 11.73 (SD .79) and the citations\' evidence value completed grade II (moderate quality: 11.26 to 12.00 scores). Work-related musculoskeletal pain and occupational injuries may lead to physical disabilities. The accidentally traumatized surgeons fought through the four CCP phases and reached successfully the PTG stage.
    UNASSIGNED: The surgical workforce is at high risk of work-related musculoskeletal morbidity which can progress to chronic pain and disruption of surgeon\'s career. Surgeons with disabilities faced serious barriers in their career. Institutions and healthcare systems must urgently develop support strategies for surgeons with disabilities.
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  • 文章类型: Journal Article
    多部位疼痛患者是否有更高的心血管疾病风险尚不清楚。
    本研究的目的是探讨多部位疼痛与心肌梗死(MI)和卒中的纵向关联,并解开这些关联的遗传因果关系。
    总共有281,760名参与者(平均年龄:56.3岁)在英国生物银行研究的基线时没有MI和卒中。髋部疼痛的数据,膝盖,背部和颈部/肩部,或者“全身”都被收集起来了。如果疼痛持续≥3个月,则定义为慢性疼痛。从入院记录和死亡登记处确定MI和卒中事件。Cox回归和2个样本孟德尔随机化用于分析。
    在11.9年的中位随访期间,4,854患有第一次MI,2,827患有第一次中风。在多变量分析中,更多的疼痛部位与更高的MI和卒中事件风险相关,在“全身疼痛”的参与者中,风险较高(MI:HR:1.65,95%CI:1.32-2.07;卒中:HR:1.44,95%CI:1.13-1.85)。在慢性疼痛患者中观察到类似的趋势和关联。双样本孟德尔随机化结果支持多部位疼痛对MI风险的因果效应,但反之亦然。多部位疼痛与卒中风险之间没有因果关系。
    多个部位的疼痛会增加心梗的风险,强调在评估个体MI风险时应该考虑疼痛,疼痛治疗和管理可以预防MI风险。
    UNASSIGNED: Whether individuals with multisite pain had a higher risk of cardiovascular diseases is unclear.
    UNASSIGNED: The purpose of this study was to investigate the longitudinal association of pain in multiple sites with incident myocardial infarction (MI) and stroke, and to disentangle the genetic causality of these associations.
    UNASSIGNED: A total of 281,760 participants (mean age: 56.3 years) who had no MI and stroke at baseline from UK Biobank study were included. Data on pain in the hip, knee, back and neck/shoulder, or \'all over the body\' were collected. Chronic pain was defined if pain had lasted for ≥3 months. MI and stroke events were determined from hospital admission records and death registries. Cox regression and 2-sample Mendelian randomization were used for the analyses.
    UNASSIGNED: During a median follow-up of 11.9 years, 4,854 had a first MI and 2,827 had a first stroke. In multivariable analyses, greater number of painful sites was dose-responsively associated with higher risks of incident MI and stroke, with a higher risk among participants with pain \'all over the body\' (MI: HR: 1.65, 95% CI: 1.32-2.07; stroke: HR: 1.44, 95% CI: 1.13-1.85). Similar trends and associations were observed in those with chronic pain. Two-sample Mendelian randomization results supported a causal effect of multisite pain on MI risk, but not vice versa. No causal association was found between multisite pain and stroke risk.
    UNASSIGNED: Pain in multiple sites causally increases the risk of MI, highlighting that pain should be considered when assessing individuals\' MI risk, and pain treatment and management may prevent MI risk.
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