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Revista de la Sociedad Española del Dolor
Print version ISSN 1134-8046
Abstract
COLLADO, A. et al. Multidisciplinary therapy for patients with chronic pain on sick leave. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.4, pp.41-47. ISSN 1134-8046.
Objective: To analyze the effectiveness of a multidisciplinary therapeutic regime in selected patients with disabling chronic pain requiring sick leave and refractory to standard therapies. Materials and methods: One hundred and four patients with disabling chronic pain received multidisciplinary intensive treatment (medical, psychological, physical and occupational therapies) five hours a day, four days a week, over 4 weeks. Revisions were scheduled at discharge and at 6 and 12 months after the end of the treatment. Results: At discharge after the treatment, significant reductions of painful, depressive and anxious symptoms were observed, as well as a significant increase of the functional capacity (Pain (VAS): 7.4±1.6 vs 3.4±2) cm (p<0.0001); Depression (BDI): 17±9 vs 10±8) points (p<0.0001); Anxiety (HARS): 19±8 vs 14±7) points (p<0.0001); Disability (HAQ): 1.7±0.4 vs 0,6±0,5 points) (p<0.0001). The sizes of the effect ranged between a maximum value of 2.5 (VAS pain) and a minimum value of 0.6 (HARS), suggesting in all the cases a wide to moderate clinical change. At that time, 75 (78%) patients have returned to their work activity. During the follow-up, the significant improvements in the output variables were maintained. Of the 62 patients that completed the one-year follow-up, 47 (63%) maintained their active work life. Conclusions: Multidisciplinary therapeutic regimes for disabling non-cancer chronic pain are effective for the relief of pain and suffering in selected patients from our setting, and reverse a high percentage of job disability.
Keywords : Chronic pain; Fibromyalgia; Multidisciplinary therapy; Work rejoin.