Comparison of a pain management program with usual care in a pain management center for people with spinal cord injury-related chronic pain.
OBJECTIVE
To evaluate the effectiveness of a specifically modified group-based, multidisciplinary cognitive-behavioral pain management program (PMP) in comparison to usual care in a clinical sample of people with spinal cord injury (SCI)-related chronic pain.


METHODS
Changes over time on a range of measures, including usual pain intensity, pain catastrophizing and self-efficacy, mood, SCI acceptance and self-efficacy, and interference due to pain were examined in 2 groups with SCI-related chronic pain after a multidisciplinary pain assessment. One group (n=19) attended the PMP, and the other (n=17) received standard care on an individualized basis in a pain management center.


RESULTS
The groups were significantly different at baseline, with the PMP group scoring more negatively on a number of the measures, including usual pain intensity. The PMP group showed an overall improvement in mood and life interference due to pain at the end of the PMP when compared with the usual care group. Within the PMP group, there was a significant improvement over time in anxiety and pain catastrophizing. No changes in SCI-related psychologic variables (acceptance and self-efficacy) were observed in either group.


CONCLUSIONS
This study demonstrates that a PMP may offer benefits to clinical populations with SCI-related chronic pain in a pain management center. The reported improvements were of a magnitude to be clinically significant. However, some of the initial benefits reported were not maintained at the nine month follow-up. The interventions may need to be augmented to address the effects of SCI-related psychologic variables that may impact upon the individual's ability to benefit from a PMP.
Perry
Kathryn Nicholson
KN
University of Sydney Pain Management and Research Centre, Royal North Shore Hospital, University of Sydney, Sydney, Australia. k.nicholsonperry@uws.edu.au
Nicholas
Michael K
MK
Middleton
James W
JW
D000328:Adult; D000339:Affect; D000368:Aged; D001315:Australia; D002388:Catastrophic Illness / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology; D018710:Pain Clinics; D059408:Pain Management; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D015397:Program Evaluation; D020377:Self Efficacy; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology / Q000628:therapy; D055815:Young Adult