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Sitting-Related Sacral Pain in Patients With Sacral Metastases: Retrospective Cross-Sectional Study.

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Τίτλος: Sitting-Related Sacral Pain in Patients With Sacral Metastases: Retrospective Cross-Sectional Study.
Συγγραφείς: Ase H; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: hase@juntendo.ac.jp., Miura K; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan., Yoshida T; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan., Kitahara E; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan., Takagi T; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Orthopedic Surgery (T.T.), Juntendo University Hospital, Tokyo, Japan; Palliative Care Center (T.T.), Juntendo University Hospital, Tokyo, Japan., Honaga K; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan., Tanuma A; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine (A.T.), Juntendo Shizuoka Hospital, Shizuoka, Japan., Tani M; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan., Murakami Y; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan., Ishikawa A; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Physical Therapy (A.I., T.F.), Juntendo University Faculty of Health Science, Tokyo, Japan., Isayama R; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan., Maeda M; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan., Fujiwara T; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Physical Therapy (A.I., T.F.), Juntendo University Faculty of Health Science, Tokyo, Japan.
Πηγή: Journal of pain and symptom management [J Pain Symptom Manage] 2026 Oct; Vol. 72 (4), pp. 467-475. Date of Electronic Publication: 2026 Jul 10.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 8605836 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-6513 (Electronic) Linking ISSN: 08853924 NLM ISO Abbreviation: J Pain Symptom Manage Subsets: MEDLINE
Imprint Name(s): Publication: New York, NY : Elsevier
Original Publication: [Madison, WI : Dept. of Anesthesiology, University of Wisconsin--Madison, 1986-
Ιατρικοί όροι (MeSH): Sacrum*/physiopathology , Spinal Neoplasms*/secondary , Spinal Neoplasms*/complications , Spinal Neoplasms*/physiopathology , Pain*/etiology , Pain*/epidemiology , Pain*/physiopathology , Sitting Position*, Humans ; Female ; Cross-Sectional Studies ; Retrospective Studies ; Male ; Middle Aged ; Aged ; Prevalence
Περίληψη: Context: Sacral metastases are uncommon but can substantially impair daily functioning through pain, neurological deficits, and instability. Sitting-related sacral pain is frequently observed clinically but has not been systematically investigated.
Objectives: To determine the prevalence of sitting-related sacral pain in those with sacral metastases and to examine the association with spinal instability and neurological symptoms.
Methods: This retrospective cross-sectional study reviewed patients with radiologically confirmed symptomatic sacral metastases who underwent inpatient rehabilitation at a single university hospital (2011-2022). Sitting-related sacral pain was defined as sacral pain present during sitting (numerical rating scale ≥4). Spinal instability was assessed using the Spinal Instability Neoplastic Score (SINS). Sacral-level neurological symptoms, including motor and sensory impairment and bladder and bowel dysfunction, were evaluated. Functional status was assessed using the Functional Ambulation Categories and the Barthel Index. All data were extracted from medical records. Associations with sitting-related sacral pain were examined using Firth's penalized logistic regression.
Results: Among 71 patients, 32 (45%) reported sitting-related sacral pain, exhibiting significantly higher SINS and poorer transfer and ambulation outcomes. In logistic regression, higher SINS was independently associated with sitting-related sacral pain (adjusted odds ratio per point, 1.56; 95% confidence interval, 1.29-1.99; p < .001); neurological symptoms were not. Sensitivity analysis confirmed result consistency.
Conclusion: Sitting-related sacral pain is common in patients with sacral metastases and is associated with spinal instability; early identification should guide rehabilitation, activity modification, and supportive care planning in palliative settings.
(Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
Contributed Indexing: Keywords: activities of daily living; bone metastasis; posture-specific pain; rehabilitation; sacral metastases; sitting position
Entry Date(s): Date Created: 20260710 Date Completed: 20260822 Latest Revision: 20260822
Update Code: 20260823
DOI: 10.1016/j.jpainsymman.2026.07.003
PMID: 42431332
Βάση Δεδομένων: MEDLINE
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  Data: Sitting-Related Sacral Pain in Patients With Sacral Metastases: Retrospective Cross-Sectional Study.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ase+H%22&quot;&gt;Ase H&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan. Electronic address: hase@juntendo.ac.jp.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Miura+K%22&quot;&gt;Miura K&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yoshida+T%22&quot;&gt;Yoshida T&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Kitahara+E%22&quot;&gt;Kitahara E&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Takagi+T%22&quot;&gt;Takagi T&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Orthopedic Surgery (T.T.), Juntendo University Hospital, Tokyo, Japan; Palliative Care Center (T.T.), Juntendo University Hospital, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Honaga+K%22&quot;&gt;Honaga K&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Tanuma+A%22&quot;&gt;Tanuma A&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine (A.T.), Juntendo Shizuoka Hospital, Shizuoka, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Tani+M%22&quot;&gt;Tani M&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Murakami+Y%22&quot;&gt;Murakami Y&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ishikawa+A%22&quot;&gt;Ishikawa A&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Physical Therapy (A.I., T.F.), Juntendo University Faculty of Health Science, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Isayama+R%22&quot;&gt;Isayama R&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Maeda+M%22&quot;&gt;Maeda M&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Fujiwara+T%22&quot;&gt;Fujiwara T&lt;/searchLink&gt;; Department of Rehabilitation Medicine (H.A., K.M., T.Y., E.K., T.T., K.H., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Hospital, Tokyo, Japan; Department of Rehabilitation Medicine (H.A., K.H., A.T., M.T., Y.M., A.I., R.I., M.M., T.F.), Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Physical Therapy (A.I., T.F.), Juntendo University Faculty of Health Science, Tokyo, Japan.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Context: Sacral metastases are uncommon but can substantially impair daily functioning through pain, neurological deficits, and instability. Sitting-related sacral pain is frequently observed clinically but has not been systematically investigated.&lt;br /&gt;Objectives: To determine the prevalence of sitting-related sacral pain in those with sacral metastases and to examine the association with spinal instability and neurological symptoms.&lt;br /&gt;Methods: This retrospective cross-sectional study reviewed patients with radiologically confirmed symptomatic sacral metastases who underwent inpatient rehabilitation at a single university hospital (2011-2022). Sitting-related sacral pain was defined as sacral pain present during sitting (numerical rating scale ≥4). Spinal instability was assessed using the Spinal Instability Neoplastic Score (SINS). Sacral-level neurological symptoms, including motor and sensory impairment and bladder and bowel dysfunction, were evaluated. Functional status was assessed using the Functional Ambulation Categories and the Barthel Index. All data were extracted from medical records. Associations with sitting-related sacral pain were examined using Firth&#39;s penalized logistic regression.&lt;br /&gt;Results: Among 71 patients, 32 (45%) reported sitting-related sacral pain, exhibiting significantly higher SINS and poorer transfer and ambulation outcomes. In logistic regression, higher SINS was independently associated with sitting-related sacral pain (adjusted odds ratio per point, 1.56; 95% confidence interval, 1.29-1.99; p &amp;lt; .001); neurological symptoms were not. Sensitivity analysis confirmed result consistency.&lt;br /&gt;Conclusion: Sitting-related sacral pain is common in patients with sacral metastases and is associated with spinal instability; early identification should guide rehabilitation, activity modification, and supportive care planning in palliative settings.&lt;br /&gt; (Copyright &#169; 2026 The Authors. Published by Elsevier Inc. All rights reserved.)
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;activities of daily living; bone metastasis; posture-specific pain; rehabilitation; sacral metastases; sitting position
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  Data: &lt;i&gt;Date Created: &lt;/i&gt;20260710 &lt;i&gt;Date Completed: &lt;/i&gt;20260822 &lt;i&gt;Latest Revision: &lt;/i&gt;20260822
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  Data: 20260823
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  Data: 10.1016/j.jpainsymman.2026.07.003
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        StartPage: 467
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      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
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      – SubjectFull: Sacrum physiopathology
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      – SubjectFull: Spinal Neoplasms secondary
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        Type: general
      – SubjectFull: Pain physiopathology
        Type: general
      – SubjectFull: Sitting Position
        Type: general
    Titles:
      – TitleFull: Sitting-Related Sacral Pain in Patients With Sacral Metastases: Retrospective Cross-Sectional Study.
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          Name:
            NameFull: Honaga K
      – PersonEntity:
          Name:
            NameFull: Tanuma A
      – PersonEntity:
          Name:
            NameFull: Tani M
      – PersonEntity:
          Name:
            NameFull: Murakami Y
      – PersonEntity:
          Name:
            NameFull: Ishikawa A
      – PersonEntity:
          Name:
            NameFull: Isayama R
      – PersonEntity:
          Name:
            NameFull: Maeda M
      – PersonEntity:
          Name:
            NameFull: Fujiwara T
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 10
              Text: 2026 Oct
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1873-6513
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Journal of pain and symptom management
              Type: main
ResultId 1