Authors (including presenting author) :
Ng HL(1), Chan PF(1), Chui TC(1) , Chin YM (1), Liu KY (1)
Affiliation :
(1) Pamela Youde Nethersole Eastern Hospital
Introduction :
Musculoskeletal chronic pain is costly and associated with poor physical and emotional functioning. While conventional treatments of using physical agents alone may lack long term benefits, congruent with the International Association for the Study of Pain (IASP), occupational therapists adopt a biopsychological approach to treat pain and utilize interventions that focus on optimizing occupational performance, developing self-efficacy and pain self-management skills.
Objectives :
This study aims at reviewing the effect of a Mind-Body Musculoskeletal Pain Management Program for neck and back pain patients, which was launched in the Outpatient Department at Occupational therapy Department of PYNEH between 2020 and 2021.
Methodology :
25 patients with chronic non-cancer neck or back pain (≥ 3 months) with symptoms affecting their ADL, work and leisure were recruited to join the Mind-Body Musculoskeletal Pain Management Program, 3 of them withdrew during the course and a total of 22 participants completed the program. This structured 4-week outpatient program is designed with reference to the model of the Active Day Patient (ADAPT) Program of Sydney’s Royal North Shore Hospital, which aims at improving function and reducing disability. Core topics include education on chronic pain model, pathology of neck and back pain, activity pacing, as well as ergonomics in daily living and stress management. Each session will include practice on stretching exercise, Dorn Self-Help method and mindfulness with aromatherapy. The physical outcome of the pain severity level included Numeric Pain Rating Scale (NPRS). Functional pain outcome measure of the Chinese Version of Pain Self-Efficacy Questionnaire (PSEQ-HK) was used. The Chinese version of Insomnia Severity Index (C-ISI) was used as a psychological measure. Each measure was taken before and after the program.
Result & Outcome :
After the completion of the program, there was significant reduction in the pain intensity level (NPRS) from 5.9 to 4.4 (Z=-2.669, p = 0.008). For the PSEQ-HK, there was significant improvement in the score from 24.4 to 26.2 (Z=2.764, p = 0.006), indicating that participants were having stronger self-efficacy in accomplishing a range of daily activities despite chronic pain after the program. There is no significant difference in the Chinese version of Insomnia Severity Index (C-ISI) before and after the program (Z = -1.720, p = 0.085). Patients with chronic pain who joined the Mind-Body Musculoskeletal Pain Management Program showed significant functional improvement physically despite the presence of chronic neck and back pain. The pain program based on physical and psychological modalities is an effective treatment and shall play an important role in chronic pain rehabilitative services in Hong Kong. A longer period of follow-up study will be required to examine the long-term effect of the program on functional and psychological aspects. Future research may also include the usage of wearable activity trackers (e.g. Fitbit) for better illustration and practice of activity pacing concept with objective outcomes on steps, active minutes and sleeping score.
