2022 年 37 巻 3 号 p. 141-148
An approach of multidisciplinary pain treatment is one of the useful methods for the treatment of chronic musculoskeletal pain because of its therapeutic effectiveness, cost–effectiveness, and smallness of iatrogenic complications. We are implementing a multidisciplinary pain treatment using a 3–week inpatient program based on the biopsychosocial model guided by the International Association for the Study of Pain (IASP) recommendations for such a program in Fukushima, Japan.
We performed the multidisciplinary inpatient pain management program for the 28 patients (10 male and 18 female) with chronic musculoskeletal pain from April 2015 to July 2021. Twenty–eight patients were classified two types by the International Classification of Diseases 11th Revision J (ICD–11J) as below; 1) 12 patients (4 male and 8 female) with chronic primary pain, and 2) 16 patients (6 male and 10 female) with secondary musculoskeletal chronic pain.
The purpose of this study was to examine the therapeutic effect of the multidisciplinary inpatient pain management program for 28 patients with secondary musculoskeletal chronic pain or chronic primary pain.
We evaluated 1) the degrees of pain using brief pain inventory (BPI), 2) the psychosocial factors in pain using pain catastrophizing scale (PCS) (rumination, magnification, and helplessness), pain disability assessment scale (PDAS), hospital anxiety and depression scale (HADS), pain self–efficacy questionnaire (PSEQ), and 3) Quality of life (QOL) using the EuroQol Five Dimensions Questionnaire (EQ–5D) and the Athens Insomnia Scale (AIS). Statistical analyses were performed using Wilcoxon matched–pairs signed rank sum test. We considered p–values less than 0.05 to be statistically significant in the variance analyses.
Comparing results before and after the program, the following statistically significant improvement in both patients with secondary musculoskeletal chronic pain and chronic primary pain were seen in PCS (magnification, helplessness, total), PDAS, HADS (anxiety, depression), PSEQ, EQ–5D. The following statistically significant improvement in only the patients with chronic primary pain were seen in BPI (p=0.017). On the other hand, the following statistically significant improvement in only the patients with secondary musculoskeletal chronic pain were seen in PCS (rumination) (p=0.032) and AIS (p=0.022).
We concluded that it would be possible to predict the therapeutic effect of the multidisciplinary inpatient pain management program broadly if the patients with chronic musculoskeletal pain were classified the pain type using ICD–11J before treatment.
