Chronic Pain Patients: Patterns of Change in Interpersonal Problems, Pain Intensity, and Depression-Anxiety

AbstractAimsTreatment of the most complex chronic pain patients, often not accepted in regular pain management programs, remains a challenge.To beable todesign interventions for these patients we must know what characterize them. The aim of this study was to characterize a subgroup of pain patients, treated in our in-patient rehabilitation programme, organized at the University Hospital in Uppsala, the only tertiary treatment for pain patients in Sweden.MethodsThe study was approved by the Regional Ethical Review Board in Uppsala (Dnr 2010/182). Seventy-two patients, consecutive new referrals seen at the rehabilitation program in 2008–2010 were enrolled and examined with a 41-item questionnaire of symptoms other than pain. The 41 symptoms were listed on an ordinal scale from 0–10, with 0–no problems and 10–severe problem. The mean pain intensity within the preceding 24-h was assessed using an 11-point NRS, numeric rating scale from 0–no problems to 10–severe problems. Information about drug-consumption was obtained from the medical record. The opioid medication was translated to morphine-equivalents dos using EAPC (European Association for Palliative Care) conversion table.ResultsSeventy-two patients were enrolled and screened, 39% men and 61% woman. Median age 45 years (range 20–70). Seventy-four percent of patients were treated with opioids, 15 patients with more than one opioid. They all reported high pain intensity, the four patients with doses over 150 mg MEq reported pain 5–8. There was no correlation between the dose of opioids and pain intensity. The patients reported 22 symptoms (median) other than pain. The number of symptoms reported using this scaleina normal population is three–four. The most common symptoms reported were lethargy, tiredness, concentration difficulties and headache reported by over 80%. Sleeping disorders and tiredness were considered as the two most problematic symptom to deal with. We found no correlation between the degree of pain and presence and severity of symptoms reported. Number of symptoms reported diminished when the dose of opioids increased.ConclusionsThe pain patient considered too complex for regular pain-management programs are characterized by reporting many symptoms other than pain. High pain intensity or high opioid-dose does not correlate to presence or severity of other symptoms, and high dose of opioids does not have a connection to low pain intensity. Many of the symptoms commonly reported – lethargy, tiredness, concentration difficulties and headache are real obstacles for successful rehabilitation, and have to be dealt with to achieve successful results.

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The visual time analog scale: simple, novel measurement approach to assess pain in patients with chronic pain

Pain Management ◽

10.2217/pmt-2020-0036 ◽

2021 ◽

Vol 11 (4) ◽

pp. 357-368

Author(s):

Akiko Okifuji ◽

Reiko Mitsunaga ◽

Yuri Kida ◽

Gary W Donaldson

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Rating Scale ◽

Chronic Back Pain ◽

Preliminary Evaluation ◽

Numerical Pain Rating Scale ◽

Chronic Pain Patients ◽

Pain Patients ◽

Pain Rating Scale ◽

Measurement Approach

Aim: We conducted a preliminary evaluation of a newly developed, time-based visual time analog (VITA) scale for measuring pain in chronic pain patients. Materials & methods: 40 patients with chronic back pain rated their pain over four visits using numerical (pain) rating scale (NRS) and VITA assessing pain intensity by distributing the amount of time spent on ‘not aware of pain’ (blue), ‘aware of nothing but pain’ (red) and time in between (yellow). Results: The NRS scores were correlated with the VITA Red but not with VITA Blue. The psychometric analyses revealed that VITA achieved greater reliability and sensitivity than did NRS. Conclusion: The results provide preliminary support for VITA scale for assessing pain intensity in patients with chronic pain.

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Soluble intercellular adhesion molecule-1: a potential biomarker for pain intensity in chronic pain patients

Biomarkers in Medicine ◽

10.2217/bmm-2016-0246 ◽

2017 ◽

Vol 11 (3) ◽

pp. 265-276 ◽

Cited By ~ 4

Author(s):

Benjamin Luchting ◽

Ludwig Christian Giuseppe Hinske ◽

Banafscheh Rachinger-Adam ◽

Leo Anthony Celi ◽

Simone Kreth ◽

...

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Adhesion Molecule ◽

Intercellular Adhesion ◽

Intercellular Adhesion Molecule ◽

Intercellular Adhesion Molecule 1 ◽

Potential Biomarker ◽

Chronic Pain Patients ◽

Soluble Intercellular Adhesion Molecule ◽

Pain Patients

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Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients

Pain ◽

10.1016/s0304-3959(98)00220-6 ◽

1999 ◽

Vol 80 (3) ◽

pp. 483-491 ◽

Cited By ~ 244

Author(s):

Paul Arnstein ◽

Margaret Caudill ◽

Carol Lynn Mandle ◽

Anne Norris ◽

Ralph Beasley

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Self Efficacy ◽

Chronic Pain Patients ◽

The Relationship ◽

Pain Patients

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Correlation between the Neuropathic PainDETECT Screening Questionnaire and Pain Intensity in Chronic Pain Patients

Medicina ◽

10.3390/medicina57040353 ◽

2021 ◽

Vol 57 (4) ◽

pp. 353

Author(s):

Sebastian Lukas König ◽

Michal Prusak ◽

Sibylle Pramhas ◽

Marita Windpassinger

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Treatment Response ◽

Rating Scale ◽

Significant Proportion ◽

Outpatient Setting ◽

Baseline Visit ◽

Wide Range ◽

Chronic Pain Patients ◽

Pain Patients

Background and Objectives: Pain is a multidimensional phenomenon with a wide range regarding the location, intensity and quality. Patients with chronic pain, in particular those suffering from mixed pain, often present a special challenge. The PainDETECT questionnaire (PD-Q) is a screening instrument designed to classify whether a patient has neuropathic pain (NP), often rated as more distressing compared to nociceptive pain. The objective of this study was to investigate whether the PD-Q score correlates with pain intensity, measured with the numeric rating scale (NRS), in chronic pain patients in an outpatient setting. Materials and Methods: A questionnaire-based study was conducted to identify the associations between the unidimensional NRS scale for pain intensity and the PD-Q score for screening of an NP component in an outpatient setting. Participants were asked to fill in the questionnaire themselves. Results: One hundred seventy-six participants completed the PD-Q questionnaire and rated pain on the NRS scale at the baseline visit. The PD-Q and NRS scores significantly correlated at the baseline visit and the 1-month follow-up visit in chronic pain patients. The identification of a neuropathic component in chronic pain may permit more targeted and effective pain management. Conclusions: The findings of our questionnaire suggest that a significant proportion of chronic pain patients had manifested features of NP at the first visit to the outpatient clinic. The PD-Q is a useful screening tool to alert clinicians of NP that may need further diagnostic evaluation or therapeutic intervention and may also help to predict treatment response. Further research is needed to investigate if a correlation is predictive of treatment response when pain therapy targets NP.

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Patient reported outcome measures of pain intensity: Do they tell us what we need to know?

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2015.12.004 ◽

2016 ◽

Vol 11 (1) ◽

pp. 73-76 ◽

Cited By ~ 6

Author(s):

David Dorfman ◽

Mary Catherine George ◽

Jessica Robinson-Papp ◽

Tanni Rahman ◽

Ronald Tamler ◽

...

Keyword(s):

Chronic Pain ◽

Activities Of Daily Living ◽

Pain Intensity ◽

Daily Living ◽

Intensity Measures ◽

Chronic Pain Patients ◽

Average Pain ◽

Time Periods ◽

The Relationship ◽

Pain Patients

AbstractObjectiveTo determine the relationship between chronic pain patients’ responses to self-report measures of pain intensity, and self-reported strategies when completing such measures.ParticipantsAmbulatory outpatients suffering from one of the following chronic pain conditions: painful HIV neuropathy, painful diabetic neuropathy, chronic Low-Back Pain.MethodAs part of a previously reported study using qualitative methods, participants completed standard pain intensity questionnaires as well as a measure of pain related disturbances in activities of daily living. In the previous study, participants’ responses during a focus group were then used to identify their strategies and beliefs about their approach to completing the questionnaires. Among the beliefs were: (1) difficulties averaging pain over different time periods (i.e., “what was your average pain during the last 24h” versus “what was your average pain during the last 2 weeks”); (2) difficulty in comparing pain from different etiologies; (3) difficulties in reporting sensations of pain in a manner unaffected by issues and situations secondary to the pain experience, such as difficulties in activities of daily living. In the present paper we use ANOVA (analysis of variance) and partial correlation to determine whether the qualitatively derived perceptions are reflected in the quantitative pain intensity scores.ResultsParticipants’ belief that it was difficult to “average” pain intensity over different time periods was supported. The data do not support their belief that pain intensity scores are affected by other factors: their specific pain diagnosis, and the extent to which pain interfered with their activities of daily living.Conclusions(1) Patients tend to report different levels of pain intensity when asked to report their pain over different periods; (2) insofar as it can be said to exist, the relationship between measures of intensity and interference with activities of daily living is minimal; (3) participants tend to report similar levels of pain intensity, irrespective of etiology.Implications(1) Chronic pain patients’ elicited beliefs and strategies concerning how they complete pain intensity questionnaires are sometimes, but not invariably, reflected in their responses to these measures. Thus, purely qualitative methodologies alone cannot provide completely reliable information and point to the need to use a “mixed methods” approach combining both qualitative and quantitative data; (2) the lack of association between pain intensity measures and interference with activities of daily living, as well as relative insensitivity to different etiologies underlines the problem in relying on pain intensity measures as the primary means of evaluating the success of a treatment, either for pain management or in clinical research.

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