The Efficacy of an Interdisciplinary Pain Management Program for Complex Regional Pain Syndrome Compared to Low Back Pain and Chronic Widespread Pain: An Observational Study
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Oxford University Press
Abstract
BACKGROUND: Little research has assessed the efficacy of interdisciplinary pain management programs (IPMPs) for complex regional pain syndrome (CRPS), whereas evidence shows that IPMPs are effective for low back pain (LBP) and chronic widespread pain (CWP). This study aimed to determine whether outcomes following an IPMP differ for people with CRPS compared to LBP and CWP. In addition, we determined whether it is possible to predict IPMP outcomes using baseline characteristics. METHODS: People with CRPS (N = 66) who had completed a 3-week IPMP were compared with age- and gender- matched controls with LBP (N = 66) and CWP (N = 66). Measures of pain intensity, pain interference and psychological factors were extracted for pre- and post-program, and at 1, 6 and 12 months. Latent class analysis identified recovery trajectories for pain intensity and pain interference. Chi-square analyses assessed differences between diagnostic groups in recovery trajectories. Machine learning models were implemented to predict recovery trajectories from baseline scores. RESULTS: Two recovery trajectories for each dependent variable (pain interference and for pain intensity) were identified: good responders and poorer responders. Following IPMPs, 37% of people belonged to a good responder recovery trajectory for pain interference, and 11% belonged to a good responder recovery trajectory for pain intensity. Recovery trajectories were equal across the three diagnostic groups (CRPS, LBP, CWP) for pain interference (χ2=1.8, p=0.4) and intensity (χ = 0.2, p=0.9). Modelling to predict outcomes correctly classified 69% of cases for pain interference and 88% of cases for pain intensity recovery trajectories using baseline scores. CONCLUSION: People with CRPS, LBP, and CWP experience similar benefits following an IPMP. This supports the use of IPMPs for people with CRPS.Description
Keywords
chronic widespread pain, cognitive behavioral therapy, Complex regional pain syndrome, fibromyalgia, interdisciplinary pain management program, low back pain, rehabilitation, chronic widespread pain, cognitive behavioral therapy, complex regional pain syndrome, fibromyalgia, interdisciplinary pain management program, low back pain, rehabilitation, 4201 Allied Health and Rehabilitation Science, 32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, 42 Health Sciences, Pain Research, Rehabilitation, Chronic Pain, Neurosciences, Back Pain, Clinical Research, Neurological, 1103 Clinical Sciences, 1115 Pharmacology and Pharmaceutical Sciences, 1117 Public Health and Health Services, Anesthesiology, 3202 Clinical sciences, 4203 Health services and systems, 5203 Clinical and health psychology
Source
Pain Medicine, ISSN: 1526-2375 (Print); 1526-4637 (Online), Oxford University Press, 26(4), 180-188. doi: 10.1093/pm/pnae126
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© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints.