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Title
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Long-term stability of pain type and severity among people with multiple sclerosis
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Type
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Presentation
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Keywords
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multiple sclerosis, neuropathic pain, pain change, pain type, pain severity, longitudinal design, generalized estimating equation, ID- Pain Questionnaire
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Abstract
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Background Given the impact of pain on the lives of people with multiple sclerosis (MS), the diagnosis and treatment of pain have received increasing attention over the past decade, but little is known about pain stability over time. Objective The main purpose of this manuscript was, among individuals with MS, to estimate the extent to which pain type and severity change over time. Methods This was a longitudinal study assessing participants’ pain type and severity at baseline and follow-up. A centre-stratified random sample comprising of 139 women and 49 men were recruited from three major MS clinics in Montreal. The McGill pain questionnaire (MPQ) and ID-Pain questionnaire (ID-Pain) were used to assess type of pain at first assessment and follow-up, respectively. The 0-10 Numeric Rating Scales (NRS) was used to assess pain severity in the sample. McNemar test and the Cohen’s un-weighted Kappa Coefficient were calculated to assess the agreement between recorded changes in pain type over time. Paired t- test was used to examine if serial ratings of NRS have been stable over time. Generalized estimating equation (GEE) was performed to test change in pain severity between the different pain type groups at first assessment and follow up. Results Results showed that, on average, all ratings of pain severity increased; however, the group-based analysis showed that pain type was stable in the majority of study participants. Results of GEE analysis suggested that pain type was a significant predictor of lowest pain severity scores over the follow-up period, while it did not emerge as significant predictor of subsequent pain ratings of worst pain severity. Conclusion The findings of this study have practical applications for chronic pain management programs. We have argued that because so many factors influence responses on pain measures, a single choice of pain aspect measured on a single occasion is less reliable than serial measures of different aspects of pain.
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Researchers
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• Nancy E. Mayo (Fourth Researcher), Susan Scott (Third Researcher), Pierre Duquette (Second Researcher), Shahnaz Shahrbanian (First Researcher)
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