Reductions in Pain Intensity Not Signs of Chronic Pain Improvement, Study Reveals

A recent study has revealed that reductions in pain intensity may not be the earliest signs of improvement chronic pain patients show in response to effective pain management.

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Researchers said that, “This study demonstrates that pain intensity scores are not robust predictors of psychosocial outcomes longitudinally. Instead, other factors such as sleep initiation, psychological distress, and disability appear to be important targets for intervention that may promote effective pain reduction.”

Utilizing retrospectively collected data from 666 treatment-seeking patients with an average age of 49.6 years where 67.9% are women with chronic pain, cross-lagged models were constructed to assess the correlation between average pain intensity and disability, sleep initiation and maintenance, and psychological distress. The analysis was performed over a 1-year time frame.

The models revealed that greater pain-related interference with sleep maintenance, but not sleep initiation, was significantly predictive of higher pain intensity at the following time point.

Additionally, more severe baseline symptoms of depression, as well as anxiety and disability significantly associated with worse pain intensity at the next time point.

On the other hand, pain intensity had no such lagged effect on depression, anxiety, or disability.

Results point to a complex temporal relationship among pain intensity and other clinical indicators of chronic pain. Specifically, while pain intensity revealed an initial lagged effect on sleep at a follow-up time point, the lack of similar effect on other significant variables suggest that intensity need not be the central measure of improvement following treatment.

Researchers said, “Our results highlight the need for multifactorial assessment and treatment of individuals with chronic pain and, further, suggest that in may not be necessary to reduce pain intensity before improvements in sleep, mood, and function can occur.”

For complete details of the study, click here.

 

Source: J Pain 2021;22:313-321

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