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Long-term experiences of pain after a fragility fracture

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Abstract

Summary

Little is known about long-term pain after a fragility fracture. In this secondary analysis, we determined that pain continues to influence many patients’ lives more than 1 year after a fracture and that health care providers do not seem to adequately recognize or manage these long-term consequences.

Introduction

We characterized perspectives on long-term pain among men and women who had sustained a fragility fracture.

Methods

We conducted a secondary analysis of qualitative data from 67 individuals recruited in three primary studies (47–89 years old; 55 women, 12 men). Eligible individuals from the primary studies were those who had reported pain related to their fracture beyond 6 months. Data about reported pain were re-analyzed using qualitative description as articulated by Sandelowski.

Results

Thirty-four individuals (47–89 years old; 4 men; 8 had sustained a vertebral fracture) reported pain related to their fracture in the primary studies. Thirty-one (91%) participants had sustained a fragility fracture at least 1 year previously (range 1–13 years). Patients described long-term pain beyond typical fracture healing times, generally unrelieved by analgesics, which affected their mobility, functional activity, independence, sleep, and energy. Health care providers were perceived to under-estimate timelines regarding the decrease of post-fracture pain and to not manage that pain. Participants reported that pain management was inadequate and that they developed their own strategies to respond to it.

Conclusions

Pain continues to influence many patients’ lives more than 1 year after a fragility fracture. Patient narratives could be useful to help health care providers to better recognize and manage this long-term consequence of fractures.

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Funding

Funding for this study was supported by the Canadian Institutes of Health Research (CGA 86802; CBO-109629), the Faculty of Medicine Dean’s Fund, University of Toronto, and the Ontario Ministry of Health and Long Term Care as part of the Ontario Osteoporosis Strategy. Joanna Sale was in part funded by a Canadian Institutes of Health Research New Investigator Salary Award and by the Ontario Ministry of Health and Long Term Care, as part of the Ontario Osteoporosis Strategy. Fiona Webster was in part funded by a Canadian Institutes of Health Research New Investigator Salary Award. The views expressed are those of the researchers and do not necessarily reflect those of the Ministry.

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Authors and Affiliations

  1. Institute of Health Policy, Management & Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada

    A. Gheorghita, F. Webster & J. E. M. Sale

  2. Geriatric Research Education and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, 98108, USA

    S. Thielke

  3. Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    J. E. M. Sale

Authors
  1. A. Gheorghita
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  2. F. Webster
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  3. S. Thielke
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  4. J. E. M. Sale
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Corresponding author

Correspondence to J. E. M. Sale.

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Gheorghita, A., Webster, F., Thielke, S. et al. Long-term experiences of pain after a fragility fracture. Osteoporos Int 29, 1093–1104 (2018). https://doi.org/10.1007/s00198-018-4399-7

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  • DOI: https://doi.org/10.1007/s00198-018-4399-7

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