Open AccessShort‐Term Functional, Emotional, and Pain Outcomes of Patients with Complex Regional Pain Syndrome Treated in a Comprehensive Interdisciplinary Pain Management Program
Author(s) -
McCormick Zachary L.,
Gag Christine M.,
Caldwell Mary,
Patel Jaymin,
Kornfeld Sarah,
Atchison James,
Stanos Steven,
Harden R. Norman,
Calisoff Randy
Publication year - 2015
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12817
Subject(s) - medicine , physical therapy , pain catastrophizing , mood , complex regional pain syndrome , chronic pain , anxiety , distress , coping (psychology) , hospital anxiety and depression scale , observational study , rating scale , clinical psychology , psychiatry , psychology , developmental psychology
Background Complex regional pain syndrome (CRPS) is difficult to effectively treat with unimodal approaches. Objective To investigate whether CRPS can be effectively treated in a comprehensive interdisciplinary pain management program. Design Observational cohort study of 49 patients aged 18–89 who fulfilled ‘Budapest Criteria’ for CRPS and completed an interdisciplinary pain management program. Preprogram to postprogram changes in physical functioning, perceived disability, emotional functioning, acceptance, coping, and pain were assessed. The measures used included: Pain Disability Index, Six minute walk test, 2‐minute sit‐to‐stand, Numerical Rating Scale, Center for Epidemiologic Studies Depression Scale, Pain Anxiety Symptoms Scale, Chronic Pain Acceptance Questionnaire, Coping Strategies Questionnaire‐Revised, RIC‐ Multidimensional Patient Global Impression of Change (RIC‐MPGIC), and Medication Quantification Scale. For worker's compensation patients, the rate of successful release to work at the end of the program was calculated. Results Results indicated significant improvements in physical functioning and perceived disability ( P 's<0.001). Patients reported increased usage of an adaptive coping strategy, distraction ( P = 0.010), and decreased usage of maladaptive and passive strategies ( P 's < 0.001). Patients showed greater chronic pain acceptance ( P 's ≤ 0.010) and reductions in emotional distress ( P 's < 0.001). Medication usage at 1‐month follow‐up was significantly reduced compared to program start ( P < 0.001) and discharge ( P = 0.004). Patients reported “much improvement” in overall functioning, physical functioning, mood, and their ability to cope with pain and flare‐ups (RIC‐MPGIC). Patient report of pain was not significantly reduced at discharge ( P =0.078). Fourteen (88%) of 16 total worker's compensation patients were successfully released to work at the end of the program. Conclusions This study demonstrates short‐term improvements in physical and emotional functioning, pain coping, and medication usage. These findings are consistent with the rehabilitation philosophy of improving functioning and sense of well‐being as of equal value and relevance to pain reduction.