The importance of monitoring patient's ability to achieve functional tasks in those with musculoskeletal pain

Abstract 

Background

Societal, clinician and patient expectations of treatment outcomes may differ due to different measures of success. This may have implications for measuring progress, monitoring treatment success and patient satisfaction.

Objective

To explore patient communication about pain.

Method

A qualitative study using in-depth interviews with people experiencing chronic pain.

Results

Thirteen people living with chronic pain were interviewed, five males and eight females. Age range 24–83 years, all had chronic pain in at least one location, 10 had low back pain. We found that the most important outcome markers for patients were functional tasks that affected their every day living. The achievement of these tasks became personal goals. Patients used task achievement to determine treatment success, regardless of whether they had to modify the way they achieved these tasks. Perception of significant pain was characterised by loss of function and inability to self-manage.

Conclusion

Treatment progress can be more meaningfully monitored by using patient determined goals, rather than clinical outcomes. Patient criteria for success were determined by achieving functional tasks/goals that had previously been difficult. The additional use of aids or encouraging adaptive behaviour should not be under estimated as part of the treatment process. However, realistic goal setting remains an important issue that patients and clinicians can jointly negotiate and address.

Keywords: Pain measurement, Pain assessment, Chronic pain, Qualitative research, Function