Spreading of Pain in Patients with Chronic Pain is Related to Pain Duration and Clinical Presentation and Weakly Associated with Outcomes of Interdisciplinary Pain Rehabilitation: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)
(2021) In Journal of Pain Research 14. p.173-187- Abstract
- Introduction: The extent to which pain is distributed across the body (spreading of pain) differs largely among patients with chronic pain conditions and widespread pain has been linked to poor quality of life and work disability. A longer duration of pain is expected to be associated with more widespread pain, but studies are surprisingly scarce. Whether spreading of pain is associated with clinical presentation and treatment outcome in patients seen in interdisciplinary multimodal pain rehabilitation programs (IMMRPs) is unclear. The association between spreading of pain and (1) pain duration (2) clinical presentation (eg, pain intensity, pain-related cognitions, psychological distress, activity/participation aspects and quality of life)... (More)
- Introduction: The extent to which pain is distributed across the body (spreading of pain) differs largely among patients with chronic pain conditions and widespread pain has been linked to poor quality of life and work disability. A longer duration of pain is expected to be associated with more widespread pain, but studies are surprisingly scarce. Whether spreading of pain is associated with clinical presentation and treatment outcome in patients seen in interdisciplinary multimodal pain rehabilitation programs (IMMRPs) is unclear. The association between spreading of pain and (1) pain duration (2) clinical presentation (eg, pain intensity, pain-related cognitions, psychological distress, activity/participation aspects and quality of life) and (3) treatment outcome were examined.
Methods: Data from patients included in the Swedish Quality Registry for Pain Rehabilitation were used (n=39,916). A subset of patients that participated in IMMRPs (n=14,666) was used to examine whether spreading of pain at baseline predicted treatment outcome. Spreading of pain was registered using 36 predefined anatomical areas which were summarized and divided into four categories: 1– 6 regions with pain (20.6% of patients), 7– 12 regions (26.8%), 13– 18 regions (22.0%) and 19– 36 regions (30.6%).
Results: More widespread pain was associated with a longer pain duration and a more severe clinical picture at baseline with the strongest associations emerging in relation to health and pain aspects (pain intensity, pain interference and pain duration). Widespread pain was associated with a poorer overall treatment outcome following IMMRPs at both posttreatment and at a 12-month follow-up, but effect sizes were small.
Discussion: Spreading of pain is an indicator of the duration and severity of chronic pain and to a limited extent to outcomes of IMMRP. Longer pain duration in those with more widespread pain supports the concept of early intervention as clinically important and implies a need to develop and improve rehabilitation for patients with chronic widespread pain. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4b63fd59-3f8e-4ca8-a646-deffb8e64ab1
- author
- Gerdle, Björn ; Rivano Fischer, Marcelo LU ; Cervin, Matti LU and Ringqvist, Åsa LU
- organization
- publishing date
- 2021-01-28
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Pain Research
- volume
- 14
- pages
- 173 - 187
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:33542650
- scopus:85100356202
- ISSN
- 1178-7090
- DOI
- 10.2147/JPR.S288638
- language
- English
- LU publication?
- yes
- id
- 4b63fd59-3f8e-4ca8-a646-deffb8e64ab1
- date added to LUP
- 2021-01-27 22:06:13
- date last changed
- 2022-04-26 23:56:06
@article{4b63fd59-3f8e-4ca8-a646-deffb8e64ab1,
abstract = {{Introduction: The extent to which pain is distributed across the body (spreading of pain) differs largely among patients with chronic pain conditions and widespread pain has been linked to poor quality of life and work disability. A longer duration of pain is expected to be associated with more widespread pain, but studies are surprisingly scarce. Whether spreading of pain is associated with clinical presentation and treatment outcome in patients seen in interdisciplinary multimodal pain rehabilitation programs (IMMRPs) is unclear. The association between spreading of pain and (1) pain duration (2) clinical presentation (eg, pain intensity, pain-related cognitions, psychological distress, activity/participation aspects and quality of life) and (3) treatment outcome were examined.<br/><br/>Methods: Data from patients included in the Swedish Quality Registry for Pain Rehabilitation were used (n=39,916). A subset of patients that participated in IMMRPs (n=14,666) was used to examine whether spreading of pain at baseline predicted treatment outcome. Spreading of pain was registered using 36 predefined anatomical areas which were summarized and divided into four categories: 1– 6 regions with pain (20.6% of patients), 7– 12 regions (26.8%), 13– 18 regions (22.0%) and 19– 36 regions (30.6%).<br/><br/>Results: More widespread pain was associated with a longer pain duration and a more severe clinical picture at baseline with the strongest associations emerging in relation to health and pain aspects (pain intensity, pain interference and pain duration). Widespread pain was associated with a poorer overall treatment outcome following IMMRPs at both posttreatment and at a 12-month follow-up, but effect sizes were small.<br/><br/>Discussion: Spreading of pain is an indicator of the duration and severity of chronic pain and to a limited extent to outcomes of IMMRP. Longer pain duration in those with more widespread pain supports the concept of early intervention as clinically important and implies a need to develop and improve rehabilitation for patients with chronic widespread pain.}},
author = {{Gerdle, Björn and Rivano Fischer, Marcelo and Cervin, Matti and Ringqvist, Åsa}},
issn = {{1178-7090}},
language = {{eng}},
month = {{01}},
pages = {{173--187}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Journal of Pain Research}},
title = {{Spreading of Pain in Patients with Chronic Pain is Related to Pain Duration and Clinical Presentation and Weakly Associated with Outcomes of Interdisciplinary Pain Rehabilitation: A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)}},
url = {{http://dx.doi.org/10.2147/JPR.S288638}},
doi = {{10.2147/JPR.S288638}},
volume = {{14}},
year = {{2021}},
}