SAT0232 Management of chronic musculoskeletal pain

Abstract

Background Objectives Of the study were to explore the management of sufferers with chronic musculoskeletal pain (CMP) syndromes. Methods A random sample of subjects was selected in the vicinity of two main outpatient clinics of the city Kaunas. All subjects aged 25–74 were requested to indicate on a mannequin any pain which had been lasting at least 24 h since the last month. Subjects who met the ACR 1990 definition for chronic widespread pain (CWP) and subjects who satisfied the standard definition of chronic low back pain (CBP) but not the ACR definition for CWP were interviewed according to a standard questionnaire. A follow-up screening of all the subjects was carried out after 6 months. Subjects who still reported CWP and CBP were classified as “persistent” CWP and CBP sufferers. Outpatient medical records of all these subjects were analysed. Results The study population comprised 1,404 subjects, 1,030 being aged 25–74. The response rate was 83.01%. The average age of respondents was 49.29 ± 13.09, 61.64% being females. The prevalence of CWP was 18.60% and CBP- 12.28%. After 6 months 88.68% of subjects with CWP and 72.38% with CBP participated in the follow-up screening. “Persistent” CWP was present in 79.43% and “persistent” CBP- in 47.37% of respondents. The majority of subjects with CWP (98.08%) and CBP (88.89%) consulted the general practitioner (GP) during the last year, mainly because of CMP. Many CWP (54.90%) and CBP (37.50%) sufferers consulted the GP 6–10 times during the last year. They were ordered a lot of investigations by the GP and were referred to specialists for medical advice (e.g., to a neurologist- 56.86% of CWP and 66.67% of CBP sufferers but to a rheumatologist- only 3.92% of CWP and 16.67% of CBP sufferers). The diagnosis was altered only in a very few cases. CBP was poorly diagnosed and fibromyalgia syndrome was not diagnosed at all by the GP. CMP patients were treated mainly with nonsteroidal anti-inflammatory drugs. No one received antidepressants, only 29.41% of CWP and 54.17% of CBP sufferers were prescribed rehabilitation procedures, but often they were hospitalised (27.45% of CWP and 29.17% of CBP cases) during the last year. Quite a big number of CWP sufferers experienced either short-time or permanent disability. Conclusion CMP syndromes are common in the outpatient population. More attention and priority for education of medical professionals concerning early diagnosis and appropriate treatment of CMP should be given by responsible health care authorities.