Introduction:
At the Pain Management Center, Hoshi General Hospital, we provide a multidisciplinary approach to chronic pain treatment, such as low back pain. This approach encompasses education, exercise therapy based on cognitive-behavioral therapy principles, psychotherapy, and pharmacotherapy. Typically, outpatient treatment is designed to span six months, with interdisciplinary team conferences determining individual treatment plans. While some patients achieve improvement or complete treatment within six months, others require extended care. This study aims to identify baseline questionnaire factors distinguishing patients who complete treatment within six months (discharge group) from those requiring longer durations (continuation group). The study includes 131 patients who completed the self-administered questionnaire at their initial visit to our Pain Management Center between April 2015 and May 2023, with no missing responses. Among these, 47 were men and 84 were women, with 97 patients in the discharge group (34 men, 63 women) and 34 patients in the continuation group (13 men, 21 women).
Methods:
The initial, three-month, and six-month assessments of chronic pain severity, pain-related psychosocial factors, and quality of life (QOL)-related outcomes were conducted through self-administered questionnaires. The Shapiro-Wilk test was used to verify data normality. Gender and age differences between the two groups were analyzed first, followed by comparisons of each evaluation item. Chi-square tests assessed gender differences, and unpaired t-tests evaluated age and item differences between groups. Statistical significance was set at p < 0.05.
Results:
No statistically significant age or gender differences were found between groups. Initial visit evaluation showed significant differences in the following: NRS (average pain) (p = 0.04), PDAS (p = 0.01), and HADS depression (p = 0.01), with these scores being significantly higher in the continuation group than in the discharge group.
Discussion:
Findings indicate that patients in the continuation group had significantly higher initial scores in NRS, PDAS, and HADS depression compared to the discharge group. These results suggest that higher initial pain severity, greater daily life impairment due to pain, and depressive symptoms may be predictive factors for extended treatment duration.
Conclusion:
Our study suggests that patients with chronic pain, particularly those with high initial pain severity, significant daily life impairment, and depressive symptoms, may require prolonged multidisciplinary treatment.