title: A cross-sectional, comparative study of pain and activity in persons with and without injection-related venous ulcers.
abstract: Persons with leg ulcers, including venous ulcers, often report pain. A cross-sectional, comparative study was conducted among 61 patients receiving care in an urban clinic (31 with and 30 without a venous ulcer, mean age 54 years [range 40 to 65 years], 93% African American) to examine pain and its relation to activity and walking in persons with injectionrelated venous ulcers. The questionnaire included items about pain and its treatment, as well as activity and walking (ie, Brief Pain Inventory [BPI] Short Form, Self-Treatment of Pain, Pain and Narcotic Use, Difficulty with Activities, and Walking Scale questionnaires). Among those with a venous ulcer (VU+), worst pain significantly related to total interference (r = 0.65, P <0.0001) and total difficulty (r = 0.42, P = 0.02) BPI scores. The common pain sites for those VU+ involved the legs (24, 36.4%), wound sites (13, 19.7%), back (eight, 12.1%), general body (five, 7.6%), shoulder and knee (four, 6.1% each), and other (eight, 12.1%). Persons VU+ were more likely than those without a venous ulcer (VU-) to have received a prescription for narcotics in the past year (96% versus 41%, X(2) = 21.3, P <0.0001). Persons VU+ versus VU- were significantly (X(2) = 8.89, P = 0.003) more likely to resort to street drug use and relapse to addiction if pain was not adequately treated. They were also twice as likely to have decreased walking over the past 5 years (67% versus 33%, X(2) = 5.93, P <0.02). Among those VU+, venous ulcers added to chronic pain and decreased walking. These findings highlight the negative effects of injection-related venous ulcers on pain, activity, and walking, as well as the propensity of this groupto resort to illicit drug use for pain control. Persons VU+ should have pain assessed and treated.
authors.affiliation: College of Nursing, Wayne State University, Detroit, MI, USA. bpieper@wayne.edu
authors.forename: Barbara
authors.initials: B
authors.lastname: Pieper
authors.forename: Ellen
authors.initials: E
authors.lastname: DiNardo
authors.forename: Cheryl K
authors.initials: CK
authors.lastname: Nordstrom
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D007871:Leg Ulcer / Q000150:complications* / Q000209:etiology; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D011795:Surveys and Questionnaires; D014647:Varicose Ulcer / Q000150:complications* / Q000209:etiology