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Pain Rehabilitation in Primary Care
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Pain Rehabilitation in Primary Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 21472

Special Issue Editors

Dr. Paul Enthoven

E-Mail Website
Guest Editor
Department of Health, Medicine and Caring Sciences (HMV), Linköping University, SE-581 83 Linköping, Sweden
Interests: chronic pain; rehabilitation; primary healthcare; musculoskeletal disorders; exercise; physiotherapy; stroke
Prof. Dr. Britt-Marie Stålnacke

E-Mail Website
Guest Editor
Department of Community Medicine and Rehabilitation, Umeå University, 90187 Umeå, Sweden
Interests: chronic pain; musculoskeletal disorders; whiplash injury; traumatic brain injury; rehabilitation; biochemical markers
Dr. Marcelo Rivano Fischer

E-Mail Website
Guest Editor
1. Department of Health Sciences, Research Group Rehabilitation Medicine, Lund University, 221 00 Lund, Sweden
2. Department of Pain Rehabilitation, Skane University Hospital, SE-221 85 Lund, Sweden
Interests: chronic pain; rehabilitation; primary healthcare; pain psychology; registry

Special Issue Information

Dear Colleagues,

Chronic pain is defined as pain that has persisted for more than 3 months and is associated with significant emotional distress and/or functional disability, where the pain is not better accounted for by another condition. Chronic pain is a major health and socioeconomic problem.

Pain is a complex multifaceted condition, since it is influenced by, and interacts with, different physical, emotional, psychological, and social factors. In addition to an individual’s daily function, activity, and participation, these problems often result in high economic costs for society. The majority of patients with pain are treated in primary care.

Interdisciplinary or multimodal rehabilitation is a standard treatment for persons with chronic pain. It has traditionally been provided in specialist pain clinics, but in recent years has also been provided in primary care. There is limited research on how interdisciplinary rehabilitation works in primary care, and more knowledge is needed about these patients in order to improve rehabilitation plans and interventions.

This Special Issue hopes to provide some answers in terms of the current health and rehabilitation issues of patients with chronic pain in primary care. This collection aims to cover a broad of topics ranging from, for example, prevention, assessment, proper management of chronic pain conditions, patient-centered care, and equity of care, as well as economic issues such as sick leave, return to work, and health care costs.

We invite healthcare professionals and researchers from around the world investigating Pain Rehabilitation in Primary Care to submit their work to this Special Issue.

Dr. Paul Enthoven
Prof. Dr. Britt-Marie Stålnacke
Dr. Marcelo Rivano Fischer
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic pain
  • rehabilitation
  • interdisciplinary pain treatment
  • primary health care
  • registries
  • return to work
  • sick leave
  • assessment
  • qualitative
  • economic evaluation

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Published Papers (4 papers)

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Research

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18 pages, 1417 KiB  
Article
Patient Education Improves Pain and Health-Related Quality of Life in Patients with Established Spinal Osteoporosis in Primary Care—A Pilot Study of Short- and Long-Term Effects
by Anna Spångeus, Catrin Willerton, Paul Enthoven and Ann-Charlotte Grahn Kronhed
Int. J. Environ. Res. Public Health 2023, 20(6), 4933; https://doi.org/10.3390/ijerph20064933 - 10 Mar 2023
Cited by 6 | Viewed by 2514
Abstract
Fragility fractures, in particular vertebral fractures, are associated with high morbidity, including chronic pain and reduced health-related quality of life. We aimed to investigate the short- and long-term effects of patient education, including interdisciplinary themes, with or without physical training or mindfulness/medical yoga [...] Read more.
Fragility fractures, in particular vertebral fractures, are associated with high morbidity, including chronic pain and reduced health-related quality of life. We aimed to investigate the short- and long-term effects of patient education, including interdisciplinary themes, with or without physical training or mindfulness/medical yoga for patients with established spinal osteoporosis in primary care. Osteoporotic persons aged sixty years or older with one or more vertebral fractures were randomized to theory only, theory and physical exercise, or theory and mindfulness/medical yoga and were scheduled to once a week for ten weeks. Participants were followed up by clinical tests and questionnaires. Twenty-one participants completed the interventions and the one-year follow-up. Adherence to interventions was 90%. Pooled data from all participants showed significant improvements after intervention on pain during the last week and worst pain, and reduced painkiller use (any painkillers at baseline 70% [opioids 25%] vs. post-intervention 52% [opioids 14%]). Significant improvements were seen regarding RAND-36 social function, Qualeffo-41 social function, balance, tandem walking backwards, and theoretical knowledge. These changes were maintained at the 1-year follow-up. Patient group education combined with supervised training seems to have positive effects on pain, and physical function in persons with established spinal osteoporosis. The improved quality of life was maintained at the 1-year follow-up. Full article
(This article belongs to the Special Issue Pain Rehabilitation in Primary Care)
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24 pages, 1872 KiB  
Article
Behavioral Medicine Physiotherapy in the Context of Return to Work for Chronic Pain: A Single-Case Experimental Design Study
by Hedvig Zetterberg, Ida Flink, Sören Spörndly-Nees, Sofia Wagner, Rolf Karlsten and Pernilla Åsenlöf
Int. J. Environ. Res. Public Health 2022, 19(3), 1509; https://doi.org/10.3390/ijerph19031509 - 28 Jan 2022
Cited by 2 | Viewed by 4085
Abstract
Effective interventions are needed for return-to-work (RTW) for individuals with chronic pain on long-term sick leave. In this study, a behavioral medicine physiotherapy protocol was systematically replicated and added to workplace components. The intervention was evaluated for fidelity and effects on target activities [...] Read more.
Effective interventions are needed for return-to-work (RTW) for individuals with chronic pain on long-term sick leave. In this study, a behavioral medicine physiotherapy protocol was systematically replicated and added to workplace components. The intervention was evaluated for fidelity and effects on target activities and work ability. A single-case experimental design was used with five participants. Daily and weekly ratings of personalized target activities at work as well as work ability were carried out throughout the study period of 26–28 weeks. Effects of the behavioral medicine physiotherapy intervention were evaluated for each individual using visual analysis of displayed graphs and quantitative non-overlap methods. Goal achievement for target activities was reviewed. Three participants completed the intervention. The results indicated an effect from the behavioral medicine physiotherapy intervention on task-specific self-efficacy for target activities, but no consistent effect on experience of target activities or work ability. All three participants had increased function in target activities in line with pre-defined goals. Fidelity to the intervention manual was good. Behavioral medicine physiotherapy can be successfully adapted to work disability and was here replicated in an RTW context for individuals with chronic pain. The intervention protocol should be further evaluated in large-scale studies. Full article
(This article belongs to the Special Issue Pain Rehabilitation in Primary Care)
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11 pages, 1621 KiB  
Article
Effects of Personal Low-Frequency Stimulation Device on Myalgia: A Randomized Controlled Trial
by Yong-Soon Yoon, Myoung-Hwan Ko, Il-Young Cho, Cheol-Su Kim, Johny Bajgai, Hong-Young Jang, Ka-Eun Kim, Kyu-Jae Lee and Mihyun Lee
Int. J. Environ. Res. Public Health 2022, 19(2), 735; https://doi.org/10.3390/ijerph19020735 - 10 Jan 2022
Cited by 1 | Viewed by 3141
Abstract
Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain [...] Read more.
Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain alleviation effects of personal low-frequency stimulation device for home use. Moreover, no studies have compared myalgia alleviation effects between personal low-frequency stimulation (PLS) and physical therapy (PT), which are most commonly used for patients with myalgia in hospitals and clinics. Therefore, we aimed to investigate the pain alleviation effects of PLS in patients with myalgia and compare these effects with those of conventional PT (transcutaneous electrical nerve stimulation + ultrasound). In total, 39 patients with myalgia in the neck, shoulder, back, and waist areas were randomly assigned to the personal low-frequency stimulation group (PLSG: n = 20) and physical therapy group (PTG: n = 19). Both groups were treated for 3 weeks (20 min per session and 5 sessions per week). Patients were assessed for pain intensity by surface electromyography (sEMG), visual analogue scale (VAS) and a short-form McGill pain questionnaire (SF-MPQ) before and after the intervention period. Our results showed that PLSG showed a tendency of muscle relaxation with a significant decrease in sEMG in the neck (p = 0.0425), shoulder (p = 0.0425), and back (p = 0.0046) areas compared to the control group. However, there was no significant difference in waist area. Additionally, VAS scores significantly decreased between pre- and post-treatment in both PTG (p = 0.0098), and PLSG (p = 0.0304) groups, but there was no significance difference between the groups. With respect to SF-MPQ, the PLSG showed greater pain alleviation (5.23 ± 0.25) effects than the PTG (6.23 ± 0.25). Accordingly, our results suggest that PLS treatment using a home device might offer positive assistance in pain alleviation for patients with myalgia that is as equally effective as conventional PT treatment. However, further detailed studies are required considering larger samples to fully claim the effectiveness of this device. Full article
(This article belongs to the Special Issue Pain Rehabilitation in Primary Care)
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Review

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15 pages, 697 KiB  
Review
Physiotherapists Using the Biopsychosocial Model for Chronic Pain: Barriers and Facilitators—A Scoping Review
by Han van Dijk, Albère J. A. Köke, Stefan Elbers, Jurgen Mollema, Rob J. E. M. Smeets and Harriët Wittink
Int. J. Environ. Res. Public Health 2023, 20(2), 1634; https://doi.org/10.3390/ijerph20021634 - 16 Jan 2023
Cited by 23 | Viewed by 10543
Abstract
The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. [...] Read more.
The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. This scoping review aimed to investigate and map these barriers and facilitators that physiotherapists working in primary care reportedly face when treating patients with chronic musculoskeletal pain from a biopsychosocial perspective. Four electronic databases (PubMed, Embase, CINAHL and ERIC) and the grey literature were searched. Studies were included if they investigated the experiences of physiotherapists in the treatment of chronic pain from a biopsychosocial perspective in primary care. Extracted data were discussed and sub grouped in themes following a qualitative content analysis approach. To align with current use of theories on behavior change, the resulting themes were compared to the Theoretical Domains Framework. After screening, twenty-four studies were included. Eight groups of barriers and facilitators were identified, thematically clustered in six themes: knowledge, skills, and attitudes; environmental context and resources; role clarity; confidence; therapeutic alliance; and patient expectations. The results of this review can be used to inform the development of implementation programs. Full article
(This article belongs to the Special Issue Pain Rehabilitation in Primary Care)
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