The impact of physical and psychological pain management training on pain intensity, anxiety and disability in patients undergoing lumbar surgeries

Abstract

BACKGROUND/CONTEXTLumbar surgery is one of the interventions performed for patients with degenerative conditions. PURPOSEThis study aimed to investigate the effect of pain management education on pain intensity, anxiety, and disability after the lumbar surgery. STUDY DESIGN/SETTINGThis randomized controlled trial was performed on 70 30-65-year-old patients with lumbar canal stenosis and lumbar disc herniation from 2018 to 2019. PATIENT SAMPLESeventy participants were randomly divided into a control and an intervention group by a randomized block design. Participants in the intervention group received in-person pain management training twice a week for seven 60-90-minute sessions. OUTCOME MEASURESAll participants in the two groups completed the study instruments (numeric rating scale [NRS], Oswestery disability index [ODI], and pain anxiety symptoms scale [PASS]) before, immediately after, and 3 months after the study. METHODSParticipants in the intervention group received in-person pain management training twice a week for seven 60-90-minute sessions. To analyze the treatment effects, repeated-measures multivariate analysis of variance (MANOVA) and effect sizes were used where appropriate and calculated by Partial ɳ2. Clinical outcome (MDC) for pain intensity and PASS was also reported. For participants lost to follow-up, we also used an “intention-to-treat” (ITT) approach. RESULTSThe results of MANOVA indicated that there were significant differences between the two groups on ratings of pain intensity, anxiety, and disability. According to the MDC, the mean differences of pain intensity for the intervention group was also clinically improved. Meanwhile, the mean differences in pain anxiety between three different times in the two groups were not above the MDC (20.14), suggesting that the clinical improvements were not significant. The results were confirmed for all outcome measures; a statistically significant difference was found between the groups in ITT analyses (p<.001). CONCLUSIONSPhysical and psychological pain management education was shown to be effective in decreasing pain intensity, anxiety, and disability. This strategy may be beneficial for such patients. Variables such as smoking behavior, past history of psychological disorders, and previous surgeries should be considered in future studies.