The pain are considered chronic as soon as they are persistent beyond what is usual for their initial cause (more often beyond 3 months), they respond poorly to treatment and they induce a deterioration of functional capacities. The most common chronic pain is headache, low back pain, neuropathic pain and osteoarthritis and musculoskeletal pain. Beyond a societal impact in both direct and indirect costs, they can, in the patient, disrupt sleep, interfere with work and relationships, and even modify the way emotions are processed by causing changes. physiological in the brain.
But the experience of chronic pain itself is complicated and varies among individuals, making it difficult to explain and quantify. According to a study published in the journal PLOS ONE, pain distribution as reported on a body map can be used to assign patients to distinct subgroups, associated with differences in pain intensity and quality, daily impact, and clinical outcome three months later. “We find that the way a patient reports bodily distribution of pain affects almost every aspect of the pain experience, including what happens three months later. », Explains the scientific team.
Neck, back, arms … notable differences depending on the location of the pain
They analyzed data from 21,658 patients seen in pain management clinics at the University of Pittsburgh between 2016 and 2019. All patients were asked to complete a body map of pain, on which it is possible to select pain areas on drawings (front and back of the body), with 74 possible body regions proposed. Further information on pain, health and patient outcomes was available in their electronic medical records. This method allowed them to discover that patients were enrolling in nine chronic pain groups different, with variations in several areas.
Thus, demographic and medical characteristics, intensity, impact and the quality of the pain varied between patient subgroups. For example, the pain intensity of the “neck and shoulder” group was lower than that of the “lower back pain radiating below the knee” group and the “neck, shoulder and lower back pain” group. », While the group presenting the highest pain intensity consisted of patients with severe pain associated with poor physical function, severe depression and severe sleep disturbances. A subset of 7,000 patients also completed a follow-up questionnaire three months after the body pain card.
A lead for personalized pain treatment
It turns out that differences also existed between the groups of patients in terms of pain improvement and physical function. While patients with abdominal pain showed the most progress, with almost half reporting significant improvement, those with neck, shoulder and lower back pain showed the worst results, with 37% improvement. . Which led the scientific team to wonder if this subgroup could be at an early stage. generalized chronic pain. “Algorithmic grouping by pain distribution could be an important facet of personalizing pain management. », She notes.
While further studies are needed to confirm the reliability of this process, the researchers hope that “this ability body pain maps Showing patients’ likely outcomes could help identify those at risk for poor outcomes on their first visit to the pain clinic. A discovery which is important since chronic pain can be responsible for drug misuse as in the case of chronic daily headaches. According to the observation recalled in the White Paper on Pain dating from 2017 and established by the French Society for the Study and Treatment of Pain, 12 million French people suffer from chronic pain 70% of whom do not receive appropriate treatment.