Chronic pain and severe disuse syndrome: long-term outcome of an inpatient multidisciplinary cognitive behavioural programme

Abstract

Objective: Patients with chronic pain and severe disuse syndrome have pain with physiological, psychological and social adaptations. The duration and severity of complaints, combined with previously failed treatments, makes them unsuitable for treatment in primary care.

Design: A prospective waiting list controlled study.

Patients: A total of 32 patients with chronic pain for at least one year and severe disuse syndrome were included in an inpatient multidisciplinary cognitive behavioural treatment.

Methods: Patients were assessed before the waiting list period, before the clinical phase, after the clinical phase and after follow-ups of 6 months and one year. The visual analogue scale for pain and fatigue were assessed. Muscle strength of the arms and legs, arm endurance and a 6-minute walking test were used to assess physical outcome. The Symptom Checklist-90, RAND-36, pain cognition list and the Tampa scale for kinesiophobia were used to assess psychological outcome.

Results: Long-term significant (p < 0.001) improvements were found for pain, fatigue, walking distance, muscle strength, anxiety, depression, somatization, negative self-efficacy, and catastrophizing in the intervention period.

Conclusion: An inpatient multidisciplinary cognitive behavioural programme is beneficial for patients with chronic pain and a severe disuse syndrome.