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Longitudinal 7-year follow-up of chronic pain in persons with multiple sclerosis in the community

Journal of Neurology volume 260, pages 2005–2015 (2013)Cite this article

Abstract

The aim of this work is to examine the course and impact of chronic pain and pain-related disability in persons with multiple sclerosis (pwMS) over a 7-year period in the Australian community employing a longitudinal, cross-sectional study using structured interviews and validated measures. The intensity of chronic pain was assessed with the visual analogue scale (VAS); the chronic pain grade (CPG) classified pain severity using scores for both pain intensity and pain-related disability, and the assessment of quality of life (AQoL) questionnaire assessed impact on participatory domains. Of the 74 pwMS assessed at 7-year follow-up (T2), 53 (71.6 %) were female, with average age of 55.6 years, and median time since diagnosis of 16.5 years. At T2, 13 (13.8 %) more participants reported chronic pain compared with baseline assessment (T1), (61 vs. 74). Although there were no significant differences on average pain intensity rating between T1 and T2 (p = 0.65), more participants at T2 reported higher rates of pain (13.1 vs. 28.4 %). At T2, participants reported greater disability limiting their daily activities due to pain (16.2 vs. 0 %), and more deterioration and dependency suggested by the AQoL domains of “Independent living” (p < 0.001) and “Physical senses” (p = 0.013). At T2, pwMS used less pharmacological medication but accessed more “other” therapy to cope with their chronic pain. This study provides longitudinal insight into the complex multidimensional chronic pain-related disability in pwMS over a longer period. Improved clinician understanding of the course of chronic pain, early intervention, and patient self-management may decrease pain-related disability and contribute to their overall well-being.

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Acknowledgments

We thank all the participants in this study, Ms. L. Oscari for interviews, A/Prof. J. Pallant for statistical input, and Prof. T. Kilpatrick for access to the RMH MS Database.

Conflicts of interest

The authors have no conflicts of interest to report.

Author information

Affiliations

  1. Department of Rehabilitation Medicine, Royal Melbourne Hospital, 34-54 Poplar Road Parkville, Melbourne, VIC, 3052, Australia

    Fary Khan & Bhasker Amatya

  2. Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia

    Fary Khan

  3. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Fary Khan

  4. Department of Neurology and Neurorehabilitation, Rehabilitation Center, Valens, Switzerland

    Jürg Kesselring

Authors
  1. Fary Khan
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  2. Bhasker Amatya
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  3. Jürg Kesselring
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Correspondence to Fary Khan.

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Khan, F., Amatya, B. & Kesselring, J. Longitudinal 7-year follow-up of chronic pain in persons with multiple sclerosis in the community. J Neurol 260, 2005–2015 (2013). https://doi.org/10.1007/s00415-013-6925-z

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  • DOI: https://doi.org/10.1007/s00415-013-6925-z

Keywords

  • Multiple sclerosis
  • Rehabilitation
  • Chronic pain
  • Quality of life
  • Disability