The Chronic Pain Patient and Functional Assessment

For treatment of chronic pain, guidelines and regulatory agencies have identified functional improvement as a primary objective, particularly when chronic opioid therapy is used. Functional improvement is frequently evaluated by qualitative questioning. The authors conducted this pilot study seeking to establish a simple and inexpensive measure of functional change for a chronic pain population. Using a multidisciplinary pain clinic standard physical therapy approach for all admitting chronic pain patients, multiple functional tests were performed, including the 6-Minute Walk Test. Data was collected by retrospective chart review, at admission to the clinic and 3-6 months later and compared using simple t-test statistics on 45 patients. The average distance walked at center admission was 272.87 yards. At 3 to 6 month clinical retesting, the distance had increased substantially to 339.04 yards (p<.0001). NRS scores at 3 to 6 months were also improved from baseline (p<.001).

They concluded that while suggestive, their study has significant limitations. Not all patients being admitted into the clinic were included in the study, only those who had completed the necessary testing. What’s more, chart reviews are complicated by the accuracy with which data is recorded. Their study is very interesting and presents positive data for a simple, inexpensive and reproducible test for physical functioning in a chronic pain population. They added that additional investigation is warranted based on these descriptive results.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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