Fatigue Links Sociodemographic Risk to Pain Intensity and Spread in Two Surgical Cohorts

Area of Science:

• Pain research
• Surgical patient outcomes
• Psychosocial factors in health

Background:

• Understanding pre-surgical pain is crucial for patient recovery and quality of life.
• Psychosocial factors are linked to pain intensity and spread, but often studied in isolation.
• Pre-surgical pain experiences can extend beyond the injury site.

Purpose of the Study:

• To examine associations between sociodemographic/psychosocial factors and pain intensity/widespread pain in pre-surgical patients.
• To investigate the role of fatigue in pre-surgical pain.
• To explore the relationship between surgical site pain, non-surgical site pain, and widespread pain.

Main Methods:

• Analysis of data from two large pre-surgical cohorts (knee replacement and thoracic surgery).
• Examination of associations between sociodemographic, psychosocial factors, and pain outcomes.
• Statistical network analysis to understand interrelationships between variables.

Main Results:

• Fatigue demonstrated the strongest and most consistent association with pain intensity and widespread pain across both cohorts.
• Fatigue was central in association networks, explaining variance in sleep disturbance, depression, stress, and socioeconomic disadvantage.
• Pain at non-surgical sites was strongly linked to widespread pain, often mediating the link between surgical-site pain and widespread pain.

Conclusions:

• Fatigue is a significant and consistent factor associated with pre-surgical pain intensity and spread.
• Fatigue plays a central role in the network of psychosocial factors influencing pain.
• Non-surgical site pain is a key indicator and mediator of widespread pain in pre-surgical populations.