Long-Term Follow-Up of Outpatient Interdisciplinary Pain Management With a No-Treatment Comparison Group1

Abstract

The long-term psychosocial and physical functioning impact of an outpatient interdisciplinary pain management program was evaluated by comparison of pain management completors and a no-treatment group. Although pain intensity did not change and there were no significant differences between groups in several aspects of daily activity, the group that completed the program reported a greater sense of control over pain, had a more hopeful outlook on the future, perceived pain as interfering less with their life, and used strategies that are considered adaptive for long-term management of pain. The results suggest that patients with chronic, complex pain problems can improve perceptions regarding pain control and reduce the interference of pain in their lives. Outlook regarding the future was identified as a critical assessment and treatment variable. Individuals who were more optimistic about the future perceived a greater control over pain and endorsed coping strategies that involve diverting attention, ignoring pain sensations, and making coping self-statements. Although pain intensity rating did not differ, individuals who had a more pessimistic outlook on life considered pain to interfere with their work activity, mood, relations with other people, and overall enjoyment of life to a greater extent than individuals who were more optimistic.

The pain experience and future expectations of chronic low back pain patients following spinal fusion

“…In this study, patients who had a negative outlook on the future reported higher pain intensity scores compared with those who had a positive outlook. These findings are in contrast with Lynch et al. (1996) who found that chronic pain patients who reported optimistic future expectations did not report lower pain intensity scores when compared with those who reported a pessimistic future expectation.…”

“…Previous studies that focused on the relationship between future expectations and pain (Hellström et al. 1999, 2000, Lynch et al. 1996) have found that those who had a positive outlook on the future perceived a greater amount of control over pain and were better able to cope with their pain compared with those who had a negative outlook on the future (Lynch et al.…”

“…1999, 2000, Lynch et al. 1996) have found that those who had a positive outlook on the future perceived a greater amount of control over pain and were better able to cope with their pain compared with those who had a negative outlook on the future (Lynch et al. 1996, Hellström et al.…”

“…1999, 2000). Of note, only one study (Lynch et al. 1996), evaluated for differences in pain intensity between patients with positive and negative outlooks toward the future and found no differences between the two groups (Lynch et al.…”

“…Previous studies that focused on the relationship between future expectations and pain (Hellströ m et al 1999, 2000, Lynch et al 1996 have found that those who had a positive outlook on the future perceived a greater amount of control over pain and were better able to cope with their pain compared with those who had a negative outlook on the future (Lynch et al 1996, Hellströ m et al 1999, 2000. Of note, only one study (Lynch et al 1996), evaluated for differences in pain intensity between patients with positive and negative outlooks toward the future and found no differences between the two groups (Lynch et al 1996). However, it is not clear whether any of the patients in these studies had undergone spinal fusion.…”