Article - Chronic Pain Patients Have Unrealistic Expectations for Treatment

January 10, 2004

Chronic Pain Patients Have Unrealistic Expectations for Treatment

By Donalee Moulton

HALIFAX, NS -- November 3, 2003 -- Patients who live with severe chronic

pain believe a cure is necessary to give them back their lives and return

them to their pre-pain activity level, according to research from University

of Toronto, Toronto, Ontario, Canada.

These expectations are not founded on medical evidence, however, and

physicians must address them to help their patients function despite their

chronic illness, the study's authors said during a presentation here October

31st at the 53rd Annual Meeting of the Canadian Psychiatric Association.

" Belief that resolution of functional disabilities depends on a cure

suggests the need to modify unrealistic treatment expectations and enhance

adaptation to illness, " said study author Diane Meschino, MD, Department of

Psychiatry, University of Toronto.

Dr. Meschino and colleagues investigated the degree to which 100 women

referred to an outpatient pelvic health centre for chronic pain reported

pain, functional problems and the feeling that these problems were related

to their pain. These factors were assessed through the use of the McGill

Pain Questionnaire, the Pain Disability Index (PDI) and the Pain and

Impairment Relationship Scale (PAIRS).

Women who reported that their level of pain was " horrible " or " excruciating "

had significantly higher disability scores than women who rated their pain

level as " discomforting. " The disability scores for feelings that their pain

affected their ability to fulfill family responsibilities were 7.0 for the

first group and 2.5 for the latter group. With respect to recreation, the

scores were 8.0 and 2.0, respectively; 8.0 and 2.0 for social activity; 6.5

and 2.0 for occupation; and 6.5 and 5.5 for sexual activity.

Patients contended that pain reduced their concentration (70%), prevented

them from doing their usual activities (65%), and reduced their quality of

life (51%), Dr. Meschino reported.

Thirty-three percent of patients believed that curing their chronic pain

would be necessary to continue their former activities (43%) and to solve

all their current problems (33%). Nineteen percent of all patients saw

themselves as disabled.

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