Multidisciplinar therapeutic program of chronic pain

Abstract

Introduction. Chronic pain is a highly prevalent disorder in developed countries, one of the main causes for medical consultations and accounts for a great percentage of economic burden. The resistance of a significant percentage of chronic pain patients to medical treatments has conveyed the development of multidisciplinar therapeutic programs.

Objective. To assess the efficacy of a multidisciplinar therapeutic program for treatment-resistant chronic pain patients with severe disability.

Material and methods. 104 sick-listed employees with chronic muskuloskeletal pain undergone an intensive multidisciplinar treatment of 4-6 weeks of duration. Patients were assessed at discharge, and at one, six and twelve months follow-up.

Results. At discharge, moderate to large clinical change was observed in all variables assessed (effect sizes between 2,5 [pain AVS] and 0,6 [HARS]). Sixty-five patients (72%) returned to work. At one, six and twelve months follow-up, the gains observed were mantained. At the end of follow-up, 47 (63%) patients out of 62 cases remained at work.

Conclusion. Our results provide further support for the efficacy of multidisciplinar therapeutic programs for disabling non-malignant chronic pain. The improvement observed reflects not only a reduction in pain intensity and in psychopathological symptomatology, along with an increased functional capacity, but the achievement of a high percentage of patients returning to work. These results are long-standing.