Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Werner, Mads


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

Online
ISSN
1877-8879
See all formats and pricing
More options …
Volume 16, Issue 1

Issues

From acute to chronic back pain: Using linear mixed models to explore changes in pain intensity, disability, and depression

Rebecca Bendayan
  • Corresponding author
  • Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga, 29071, Spain
  • MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, United Kingdom
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Carmen Ramírez-Maestre
  • Department of Personality, Assessment and psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga, 29071, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Emilio Ferrer
  • Department of Psychology, University of California, Davis, One Shields Ave., Davis, CA 95616-8686, United States
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Alicia López
  • Department of Personality, Assessment and psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga, 29071, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Rosa Esteve
  • Department of Personality, Assessment and psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga, 29071, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-07-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.02.009

Abstract

Background/aims

This longitudinal study investigated the pattern of change in pain intensity, disability, and depression in 232 chronic pain patients who were followed up for 2 years since pain onset. Most studies that have investigated changes in these variables over time have used participants who had already been in pain for more than 3 months. Few studies have followed up individuals from the acute phase onward and such studies used traditional statistical methods that cannot identify transition points over time or measure inter-individual variability.

Methods

We followed up individuals with chronic pain from pain onset up to 18 months and we examined their pain intensity, disability and depression trajectories using a modelling approach that allows to account for between and within-individual variability. We compared three patterns of change based on theoretical criterions: a simple linear growth model; a spline model with a 3-month transition point; and a spline model with a 6-month transition point. Time with pain was selected as time metric to characterise the change in these variables in the transition from acute to chronic pain. Sex and age differences were also examined.

Results

The results showed that the pain intensity trajectory was best represented by the spline model with a 3-month transition point, whereas disability and depression were best explained by linear growth models. There were sex differences at intercept level in all the models. There were age differences at baseline for pain intensity. No sex or age differences were found for the slope.

Conclusions

Pain intensity decreased in the first 3 months but underwent no further change. Disability and depression slightly but constantly decreased over time. Although women and older individuals are more likely to report higher pain intensity or pain-related disability in the first three months with pain, no differences by sex or age appear to be associated with the changes in pain intensity, depression and disability through the process of chronification.

Implications

Our findings suggest that pain chronification could be considered a continuous process and contribute to the ongoing discussion on the utility of standard classifications of pain as acute or chronic from a clinical point of view. Clinical and intervention decisions based in these standard classifications should consider the differences in the trajectories of pain related variables over time. In addition, this article illustrates a statistical procedure that can be of utility to pain researchers.

This article offers supplementary material which is provided at the end of the article.

Keywords: Chronic pain onset; Pain intensity; Depression; Disability; Change

References

About the article

Departmento de Psicobiologia y Metodologia de las CC. Del C., Faculted de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain


Received: 2016-09-10

Revised: 2017-02-03

Accepted: 2017-02-21

Published Online: 2017-07-01

Published in Print: 2017-07-01


Ethical issues: This research project was approved and registered by the Carlos Haya Hospital Ethics Committee. Informed consent was obtained prior to data collection.

Conflict of interest: None declared.


Citation Information: Scandinavian Journal of Pain, Volume 16, Issue 1, Pages 45–51, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.02.009.

Export Citation

© 2017 Scandinavian Association for the Study of Pain.Get Permission

Supplementary Article Materials

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Carlos Suso-Ribera, Laura Camacho-Guerrero, Jorge Osma, Santiago Suso-Vergara, and David Gallardo-Pujol
Frontiers in Psychology, 2019, Volume 10
[2]
Marion K. Slack, Ramon Chavez, Daniel Trinh, Daniel Vergel de Dios, and Jeannie Lee
Scandinavian Journal of Pain, 2018, Volume 18, Number 4, Page 645

Comments (0)

Please log in or register to comment.
Log in