Longitudinal seven-year follow-up of chronic pain in persons with multiple sclerosis in the community

In this longitudinal cross-sectional study over seven years from Australia, the researchers examined the course and impact of chronic pain and pain-related disability in people with MS. They used the visual analogue scale (VAS) to assess the intensity of chronic pain, the chronic pain grade (CPG) classified pain severity using scores for both pain intensity and pain-related disability, and the assessment of quality of life (AQoL) questionnaire assessed impact on participatory domains. Of the 74 people with MS assessed at seven-year follow up (T2), 13.8 % more participants reported chronic pain compared with baseline assessment (T1). There were no significant differences on average pain intensity rating between T1 and T2, but more patients at T2 reported higher rates of pain (13.1% versus 28.4%). At T2 16.2% of participants reported greater disability limiting their daily activities due to pain. At T2, people with MS used less pharmacological medication but accessed more other therapies to manage with their chronic pain. 

This study demonstrates the complexity of chronic pain-related disability over a longer period. The researchers conclude that improved clinician understanding in relation to the course of chronic pain, in addition to early intervention and patient self-management, may decrease pain-related disability and improve overall well-being.

Authors: Khan F, Amatya B

Source: J Neurol. 2013 Apr 25. [Epub ahead of print]

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