Positive Effects of a Musculoskeletal Pain Rehabilitation Program Regardless of Pain Duration or Diagnosis

Abstract

Objectives: To investigate how socio-demographic and clinical factors were associated with psychosocial functioning and disability at admission and at a 1-year follow-up. Design:A cohort pre-post study.Setting: A University hospital specialized pain rehabilitation unit.Participants: Five hundred and nine participants with musculoskeletal pain (neck disorders 29%, fibromyalgia 24%, low back pain 24%, myalgia 14% and other pain diagnoses 8%).Intervention: A 5-week outpatient, group-based, and goal-oriented comprehensive musculoskeletal interdisciplinary pain rehabilitation program based on cognitive behavioral principles. Main outcome measures:The Multidimensional Pain Inventory (MPI), the Disability Rating Index (DRI), and forms including socio-demographic (sex, age, ethnicity, marital status, educational level and vocational situation) and clinical factors (pain duration and pain diagnoses). Data were analyzed with multivariate logistic regression.Results: At admission, factors associated with more positive scores on the MPI were being older than 40 years, being at work, being Nordic born, attainment of a higher educational level and a diagnosis of fibromyalgia (compared with a neck disorder) (P < .05). Being at work and a diagnosis of fibromyalgia (compared with low back pain) were associated with more positive scores on the DRI (P < .05). On the basis of cut points for clinically important change on the MPI, participants rated themselves as most improved on the Affective Distress (52%), Life Control (49%) and Pain Severity (43%) subscales, and on the DRI index improvement rate was 22%. At the 1-year follow-up, neither socio-demographic nor clinical factors were associated with clinically important improvements of the MPI and the DRI, but lower age was related to deteriorations on pain severity.3 Conclusions:The lack of an association between socio-demographic and clinical factors and psychosocial functioning and disability at a 1-year follow-up after a musculoskeletal pain rehabilitation program suggests that the program was effective regardless of the participants' initial characteristics, except for age. The changes at the 1-year follow-up indicate that the program influenced the participants' psychosocial functioning more than their perception of disability.

Improved life satisfaction and pain reduction: Follow-up of a 5-week multidisciplinary long-term pain rehabilitation programme

“…The only factor that emerged was age; patients aged 38 years and above showed significantly less affective distress after the programme compared with patients younger than 38 years. The importance of this single positive statistical finding must be interpreted with caution, but is in accordance with findings by Persson et al (22). It is possible that older age may be associated with more expectations of pain as a part of everyday life and therefore less affective distress.…”

”Change is possible”: Patients’ experience of a multimodal chronic pain rehabilitation programme

“…The most evidence-based and recommended treatment is multimodal, multidisciplinary rehabilitation programmes (11,12). While studies have shown that it is possible to reduce pain and disability and thus improve psychological well-being as well as quality of life (13,14), questions remain about how to tailor multimodal programmes to meet individual needs (11,12).…”

Everyday occupational problems perceived by participants in a pain rehabilitation programme

“…Belongings to different pain diagnostic subgroups were also found to be differently associated with activity limitations and physical disability (18). One study suggested that pain management 3 strategies that target functional disability may be particularly important in the treatment of women (19).…”