Evaluation of long-term health outcomes in patients with subacute and persistent musculoskeletal pain : A longitudinal study

Abstract: Background: The present study evaluated changes in long-term health outcomes in patients with subacute and persistent musculoskeletal pain (MSP) treated in two conditions in primary healthcare settings. Investigated were also the relationships among these health outcomes.  Methods: Within a longitudinal design, pain-related disability, pain intensity, self-efficacy, catastrophic thinking and fear of movement of patients diagnosed with subacute and persistent musculoskeletal pain (n = 29) were assessed over five years. Non-parametric statistical analyses were applied. Results: Significant changes were found between post-intervention and 5-year follow-up measurements of catastrophic thinking in the active implementation (AIS) group and between pre- and post-intervention measurements of pain intensity in the passive implementation (PIS) group. No change was found between the groups in PDI change scores between the post-intervention and the 5-year follow-up measurement. Self-efficacy at pre-intervention showed a strong significant negative correlation with the Pain Disability Index (PDI) at the 5-year follow-up in the AIS group, and the fear of movement at pre-intervention a significant moderate correlation. Self-efficacy at post-intervention presented a moderate significant correlation with PDI at the 5-year follow-up in both groups. Conclusion: Few significant changes in the participants’ health outcomes within five years post-intervention were identified. Self-efficacy and fear of movement seem to play a significant role in the long-term development of pain-related disability. However, these results need to be interpreted cautiously, and further research is warranted regarding determinants of disability developments in patients with subacute and persistent MSP.