Adverse Impacts of Chronic Pain on Health-related Quality of Life, Work Productivity, Depression and Anxiety in a Community-based Study

Background:   Chronic pain has major clinical and social consequences. Few studies have examined any variation in the extent of impairment on quality of life and work productivity by site and type of chronic pain.

Objective:   The objective of our study is to examine adverse impacts of chronic pain on physical and psychological health and work productivity.

Methods:   Our community-population study was based on a phone-interview of adults with chronic pain, residing in Olmsted County, MN. Chronic pain groups were categorized into abdominal pain, back pain, joint pain, multisite pain, neuropathic pain or no chronic pain. We used standardized instruments, including the Brief Pain Inventory, the Patients Health Questionnair-9, and Work Productivity and Activity Impairment Questionnaire.

Results:   We evaluated 591 patients suffering from chronic pain and 150 participants with no chronic pain. Almost one third of patients with multisite pain (33%) and neuropathic pain (32%) reported mild/major depressive symptoms. Patients suffering from chronic pain, particularly from multisite pain and neuropathic pain, reported significant pain interferences with daily activities and impairments in physical function. Chronic pain was significantly associated with reduced performance at work but not with missed work hours. The average reported reduction in work productivity ranged from 2.4 hours (±5.6) per week for adults with joint chronic pain to 9.8 hours (±11.1) per week for adults with multisite chronic pain.

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Conclusions:   Chronic pain, particularly multisite pain and neuropathic pain, significantly affected physical and psychological health. Chronic pain is a multifaceted health condition that requires a multidisciplinary treatment approach.

Keywords:   Chronic pain; depression; epidemiology; pain; primary health care; quality of life.

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Introduction

Chronic pain is a common condition that has major clinical and social consequences in communities. [1, 2] Chronic pain can be manifested in different locations and types, including low back pain, abdominal pain, joint pain, multisite pain and may be neuropathic in nature. Differing types and sites of chronic pain, may differentially impact physical and psychological well-being and work productivity. [2] Few studies have examined the reduction in work productivity by type and location of chronic pain. Most prior studies focused on specific types of pain rather than locations of pain or did not differentiate by type or location of pain. [3–5] Furthermore, they often included patients recruited in the clinic or hospital setting, and thus results may not generalize to community populations.

The objective of our community population-based study was to characterize chronic pain by location and whether or not it was neuropathic to examine adverse impacts on interference with daily activities, work and physical and psychological well-being compared to a group of patients without chronic pain. By sampling participants from the community rather than from health care utilization databases, we were able to examine these associations in chronic pain sufferers with and without healthcare seeking for their symptoms. Our study was based on a phone-interview of adults with chronic pain, residing in Olmsted County, Minnesota (MN).

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