Pain, Pain Identity, and Self-rated Health Among Adults With Chronic Pain Before and After Treatment

Abstract

Background: To assess changes in pain levels, self-rated health (SRH) and identity of a pain patient in adults with chronic pain from referral to implantation of a spinal cord stimulation (SCS) device to ~6 weeks following implantation. Methods: Patients with chronic pain (N=148) filled in questionnaires at referral to SCS (T1) and ~8 months later (T2; n=119), including ratings of pain and general health (SRH), acceptance of pain (indicating identification with being a pain patient), and the IPQ-R. Findings: 20% did not undergo SCS (no SCS=nSCS), 29% underwent only temporary implantation of a SCS device and discontinued ("disappointed"=dSCS), and 51% continued to permanent SCS (pSCS). Repeated measures ANOVA showed that pain levels significantly decreased in the dSCS and much more so in the pSCS but remained the same in the nSCS. SRH and pain perceptions improved only for the pSCS whereas stronger pain identity was reported only by the dSCS. Discussion: Continuous use of SCS relieves pain and leads to improved SRH yet pain still dominates these patients' lives and thoughts. Failing treatment leads to even stronger pain identity and intrusion, despite some improvement in pain level.