Interdisciplinary Multimodal Pain Rehabilitation in Patients with Chronic Musculoskeletal Pain in Primary Care-A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)

Evaluation of a Four Week Interdisciplinary Multimodal Pain Therapy on Chronic Pain Patients-A Comprehensive Approach

Chronic pain syndrome poses a significant challenge to healthcare systems worldwide, affecting millions of individuals and resulting in reduced quality of life and substantial socio-economic costs. This prospective, non-interventional, single-center study evaluated the effectiveness of a four-week interdisciplinary multimodal pain therapy (IMPT) program incorporating neuromuscular training with the HUBER® 360 evolution device. The study included 66 patients diagnosed with chronic pain disorder, divided into an intervention group (n = 49) that completed weekly supervised HUBER® 360 sessions and a control group (n = 17). Measurements were taken at four time points: day of admission (t1), during therapy (t2), at discharge (t3), and three months post-discharge (t4). The study assessed changes in psychological factors, pain intensity, postural control, and quality of life. The results show that this four-week therapy led to significant improvements in psychological factors such as depression, anxiety, and stress, and significantly reduced the subjects' pain. The intervention group showed more pronounced improvements compared to the control group. These findings highlight the potential benefits of IMPT in managing chronic pain and improving both physical and psychological health outcomes. This study contributes to the ongoing development of chronic pain management strategies, emphasizing the importance of a multidisciplinary, patient-centered approach. Future research should explore the scalability of IMPT, stratify results based on demographic factors, and evaluate the long-term efficacy of adjunctive tools like the HUBER® 360 device.

Integrated Approach to Chronic Pain-The Role of Psychosocial Factors and Multidisciplinary Treatment: A Narrative Review

BACKGROUND

Chronic non-malignant pain represents a growing global public health priority. Chronic pain is multifactorial, with numerous biological, psychological, and social factors contributing to this pain syndrome. It affects not only the patients, impairing their quality of life, but also their family and social environment. Chronic pain is a diagnosis and requires effective and sustainable treatment strategies.

OBJECTIVE

Our aim was to critically review the available evidence on the importance of different approaches in treating patients with chronic non-malignant pain, emphasizing the effectiveness of integrating psychological and social factors within a multidisciplinary framework.

METHODS

This was a non-systematic narrative review of the basic and recent literature analyzing approaches to the treatment of chronic non-malignant pain. The inclusion criteria for the papers were chronic non-malignant pain, treatment approach, review, and original research papers published in English in the last five years (PubMed search), and the basic literature was selected from the references of new papers according to the knowledge and experience of the authors.

RESULTS

This literature review included 120 papers, of which 83 were basic, and 37 were new, published in the last 5 years (2018-2023). The results show that both the basic and newly published literature advocate for a biopsychosocial approach to treating chronic pain.

CONCLUSIONS

New findings, compared to the earlier literature, indicate a new classification of chronic pain into primary and secondary. Chronic pain should be approached with a biopsychosocial model within a multidisciplinary treatment framework. This model addresses the complex interplay of biological, psychological, and social factors, offering a holistic strategy for effective pain management.

The High Burden of Acute and Chronic Pain in General Practice in French-Speaking Belgium

Background

Chronic pain prevalence is very high in the general population, much higher than can be managed by chronic pain centers. Therefore, most pain patients are cared for by first-line professionals. However, general practitioners often feel ill at ease with these patients, and only a few studies assess the burden of chronic pain in general practice. To better estimate the resources needed to support these professionals, a good knowledge of (sub)acute and chronic pain prevalence and prognosis in general practices is needed.

Methods

We report cross-sectional data from a larger longitudinal study performed in French-speaking general practices in Belgium in November 2018. Fifth-year medical students performing a one-month internship collected data for every third patient they saw each day: demographic information, pain characteristics, lifestyle, general health perception and the short Örebro Musculoskeletal Pain Screening Questionnaire in the French language.

Results

3882 patients (participation rate 66%) accepted to take part in the study. 22 and 50% of these suffered from (sub)acute and chronic pain, respectively. Pain was more often the motive of the consultation for (sub)acute than for chronic pain patients. Pain intensity and functional impact were moderate, irrespective of pain duration. 70% of (sub)acute and 31% of chronic pain patients were at low risk of chronicity.

Conclusion

In our sample, chronic pain patients constituted 33-50% of patient contacts in general practice, indicating the high importance of providing adequate support to general practitioners and other first-line professionals, ie, by reinforcing collaboration with chronic pain centers.