What do patients say about the evolution of their chronic pain?

currently, there is little knowledge about possible trajectories of chronic pain development, especially in relation to other common symptoms (sleep and vitality). Meaningful involvement of people with lived experiences in pain research by listening to their stories could advance the development of therapies. By analysing patients' testimonies about the development of chronic pain and accompanying medical records, we aimed to identify specific patterns in the development of pain and other symptoms and to explore possible differences among the patient groups that emerged. Methods: We included 487 consecutive patients aged 18+ years who attended the subspecialty outpatient clinic for rehabilitation of individuals with chronic nonmalignant pain from February to November 2019. To characterise the origin and time course of symptom development, we used 16 binary descriptors. Participants completed two questionnaires on pain, and we collected data on preexisting and comorbid conditions, motor ability tests, body mass index, medication, and socioeconomic status. Results: The majority of participants reported initial persistent low back pain. One-third of them reported an estimated duration of daily pain of less than 5 years; 16% reported a duration of more than 20 years. Only one-third of the participants reported no concomitant headaches. Hierarchical clustering based on descriptors distinguished three groups: Pain symptoms generally developed gradually, from regional to widespread pain in adulthood, fatigue and sleep disturbance occurred as pain symptoms spread; pain symptoms developed either in childhood or suddenly after injury, concomitant problems occurred after the onset of pain symptoms; physical fatigue developed before the onset of physical pain, which generally developed gradually from regional to widespread pain. The fourth group was those with an unclear history. The data on concomitant diseases revealed a wide range of diagnoses not normally associated with the development of pain syndromes. Some important differences between groups were noted. Conclusion: Based on patients' medical histories, we uncovered some possible developmental pathways of chronic pain syndrome related to baseline symptoms (widespread pain, headache, physical or mental fatigue, sleep disturbances). A better understanding of the development of chronic pain syndromes could contribute to the discovery of key pathophysiological mechanisms and to more targeted, effective, and earlier interventions.

Biography :

Helena Jamnik is an experienced clinician, at the moment head of the outpatient department at University Rehabilitation Institute of Ljubljana, involved in clinical research, with experiences in organization of health service, team leadership, working closely with different clients or collaborators, patients, health professionals, management staff and academics. She is specialized in physical medicine and rehabilitation in July 2007, experienced in rehabilitation of different types of disabilities, specialized in chronic pain management in interdisciplinary pain rehabilitation programs.

HTML