By: Allison Gandey – Authors and Disclosures – Medscape
May 24, 2011 (Austin, Texas) — More than half of patients with multiple sclerosis in a new study reported moderate to severe pain that limits function.
“Pain is common in people with multiple sclerosis,” lead investigator Denis Martin, DPhil, from Teeside University in Middlesbrough, the United Kingdom, toldMedscape Medical News. “This should reinforce to clinicians to ask about pain and how it may be affecting the person. Too often that can be overlooked or dismissed.”
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| MS patients reported pain in 1 or more areas during the past 3 months |
Presenting here at the American Pain Society annual meeting, the researchers showed that 54% of their sample experienced pain in 1 or more areas during the past 3 months. These patients had a statistically significant worse outcome on the World Health Organization Disability Assessment Schedule II (P < .05).
The results are from a subanalysis of a study assessing function in patients with multiple sclerosis using textured insoles in footwear. The researchers did not present the results of the primary analysis, which they say are being prepared for publication.
The subanalysis included 46 people with multiple sclerosis. Patients reported levels of pain in their wrist, hand, back, hip, knee, and foot using numeric rating scales ranging from 0 to 10. Investigators then compared function in patients with and those without pain.
Although the research team did see more disability in patients experiencing pain, they did not observe a significant difference on the Multiple Sclerosis Walking Scale or in measures of balance and gait (P > .05).
“A bigger study would be needed to address questions such as what particular type of person is most affected, which areas of the body are most affected, and what are the precise prevalence and incidence rates,” Dr. Martin said. “The study did not try to establish the nature of pain, only its presence, so there is more work needed.”
Accepting the Pain
In a separate presentation here at the meeting, investigators looked at the role of pain-related acceptance in improving quality of life.
Previous studies of chronic pain have found that patients who are able to accept that discomfort is a part of their lives fare better than those who resist it.
Adam Hirsh, PhD, and his team from the University of Washington in Seattle wanted to know whether the pain-related psychological experience of people with multiple sclerosis is different from that of people without the disease.
Investigators studied 129 people with multiple sclerosis and chronic pain. Patients completed measures assessing pain acceptance, intensity, interference, depression, and quality of life.
Compared with a previously published mixed chronic pain sample, the patients with multiple sclerosis reported significantly greater overall pain acceptance, activity engagement, and pain willingness (P < .001).
After controlling for pain intensity, regression analysis suggested that activity engagement and pain willingness were significant predictors of pain interference and depression. Only activity engagement was a significant predictor of quality of life.
“Since greater pain acceptance was associated with lower levels of pain interference and depression and better quality of life in patients with multiple sclerosis,” the investigators reported, “rehabilitation providers should consider ways to enhance pain acceptance to maximize the clinical outcomes of these patients.”
The researchers have disclosed no relevant financial relationships.
American Pain Society 30th Annual Scientific Meeting. Posters 202 and 403. Presented May 19 and 20, 2011.
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