Multidisciplinary pain management program for patients with chronic musculoskeletal pain in Japan: a cohort study

Naoto Takahashi,1,2 Kozue Takatsuki,1 Satoshi Kasahara,1,2 Shoji Yabuki1,21Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima 9601295, Japan; 2Pain Management Center, Hoshi General Hospital, Koriyama 963-8501, JapanCorrespondence: Naoto TakahashiDepartment of Pain Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, JapanTel +81 24 547 1964Fax +81 24 547 1966Email naoto-t@fmu.ac.jpIntroduction: Multidisciplinary pain management is a useful method for treating chronic musculoskeletal pain. Currently, few facilities in Japan offer multidisciplinary pain treatment, especially in the inpatient setting. We implemented a multidisciplinary pain management program based on International Association for the Study of Pain recommendations. This study described our initial efforts in implementing the program, and reported 3- and 6-month follow-up results.Materials and methods: Our pain management team included orthopedic surgeons, psychiatrists, nurses, physical therapists, clinical psychologists, pharmacists, and nutritionists. The 3-week inpatient pain management program comprised exercise therapy, psychotherapy, and patient education. We evaluated patients using the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Pain Disability-Assessment Scale (PDAS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), EuroQol Five Dimensions (EQ-5D), and physical examinations (flexibility, muscle endurance, walking ability, and physical fitness). Statistical analyses were performed using paired t-tests and Wilcoxon matched-pairs signed-rank sum tests with Bonferroni correction after the Friedman test.Results: Data for 23 patients were analyzed before and immediately after the program. Statistically significant improvements were seen in BPI, PCS, PDAS, HADS, PSEQ, EQ-5D, flexibility, muscle endurance, walking ability, and physical fitness. Eight patients were also assessed 3 and 6 months after the program. PCS (rumination and helplessness) scores and flexibility showed significant improvement at 3 and 6 months. Significant improvement was seen in PDAS and HADS (anxiety) scores and muscle endurance at 6 months, and in PSEQ scores immediately and at 3 and 6 months.Conclusion: Our inpatient pain management program can improve patients’ physical function and ability to cope with chronic musculoskeletal pain, which supports improved quality of life. Our program is currently being expanded to better assist patients with chronic musculoskeletal pain.Keywords: chronic musculoskeletal pain, multidisciplinary pain treatment, biopsychosocial model, inpatient pain management program