The Effect of Peer Group Management Intervention on Chronic Pain Intensity, Number of Areas of Pain, and Pain Self-efficacy

Overview

Journal Scand J Pain

Publisher De Gruyter

Specialty Psychiatry

Date 2025 Feb 27

PMID 40014757

Authors

Marjatta Inkeri Reilimo

Markku Sainio

Juha Liira

Marjukka Laurola

Affiliations

Soon will be listed here.

Abstract

Objectives: Chronic pain causes loss of workability, and pharmacological treatment is often not sufficient, whereas psychosocial treatments may relieve continual pain. This study aimed to investigate the effect of peer group management intervention among patients with chronic pain.

Methods: The participants were 18-65-year-old employees of the Municipality of Helsinki (women 83%) who visited an occupational health care physician, nurse, psychologist, or physiotherapist for chronic pain lasting at least 3 months. An additional inclusion criterion was an elevated risk of work disability. Our study was a stepped wedge cluster, randomized controlled trial, and group interventions used mindfulness, relaxation, cognitive behavioral therapy, and acceptance and commitment therapy. We randomized sixty participants to either a pain management group intervention or to a waiting list with the same intervention 5 months later. After dropouts, 48 employees participated in 6 weekly group meetings. We followed up participants from groups A, B, and C for 12 months and groups D, E, and F for 6 months. As outcome measures, we used the pain Self-Efficacy Questionnaire, the number of areas of pain, the visual analog scale of pain, and the pain self-efficacy. We adjusted the results before and after the intervention for panel data, clustering effect, and time interval.

Results: The peer group intervention decreased the number of areas of pain by 40%, from 5.96 (1-10) to 3.58 ( < 0.001), and increased the pain self-efficacy by 15%, from 30.4 to 37.5 ( < 0.001). Pain intensity decreased slightly, but not statistically significantly, from 7.1 to 6.8.

Conclusions: Peer group intervention for 6 weeks among municipal employees with chronic pain is partially effective. The number of areas of pain and pain self-efficacy were more sensitive indicators of change than the pain intensity. Any primary care unit with sufficient resources may implement the intervention.

References

Freynhagen R, Parada H, Calderon-Ospina C, Chen J, Emril D, Fernandez-Villacorta F . Current understanding of the mixed pain concept: a brief narrative review. Curr Med Res Opin. 2018; 35(6):1011-1018. DOI: 10.1080/03007995.2018.1552042. View

Zimmer Z, Fraser K, Grol-Prokopczyk H, Zajacova A . A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain. 2022; 163(9):1740-1750. PMC: 9198107. DOI: 10.1097/j.pain.0000000000002557. View

Guido D, Leonardi M, Mellor-Marsa B, Moneta M, Sanchez-Niubo A, Tyrovolas S . Pain rates in general population for the period 1991-2015 and 10-years prediction: results from a multi-continent age-period-cohort analysis. J Headache Pain. 2020; 21(1):52. PMC: 7218619. DOI: 10.1186/s10194-020-01108-3. View

Emilson C, Asenlof P, Demmelmaier I, Bergman S . Association between health care utilization and musculoskeletal pain. A 21-year follow-up of a population cohort. Scand J Pain. 2020; 20(3):533-543. DOI: 10.1515/sjpain-2019-0143. View

Lumley M, Schubiner H . Psychological Therapy for Centralized Pain: An Integrative Assessment and Treatment Model. Psychosom Med. 2018; 81(2):114-124. PMC: 6355353. DOI: 10.1097/PSY.0000000000000654. View

Tschudi-Madsen H, Kjeldsberg M, Natvig B, Ihlebaek C, Dalen I, Kamaleri Y . A strong association between non-musculoskeletal symptoms and musculoskeletal pain symptoms: results from a population study. BMC Musculoskelet Disord. 2011; 12:285. PMC: 3310803. DOI: 10.1186/1471-2474-12-285. View

Tsang A, Von Korff M, Lee S, Alonso J, Karam E, Angermeyer M . Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. J Pain. 2008; 9(10):883-91. DOI: 10.1016/j.jpain.2008.05.005. View

Fletcher D, Stamer U, Pogatzki-Zahn E, Zaslansky R, Tanase N, Perruchoud C . Chronic postsurgical pain in Europe: An observational study. Eur J Anaesthesiol. 2015; 32(10):725-34. DOI: 10.1097/EJA.0000000000000319. View

Shraim B, Shraim M, Ibrahim A, ELgamal M, Al-Omari B, Shraim M . The association between early MRI and length of disability in acute lower back pain: a systematic review and narrative synthesis. BMC Musculoskelet Disord. 2021; 22(1):983. PMC: 8614033. DOI: 10.1186/s12891-021-04863-9. View

10.

Vlaeyen J, Linton S . Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000; 85(3):317-332. DOI: 10.1016/S0304-3959(99)00242-0. View

11.

Rivara F, MacKenzie E, Jurkovich G, Nathens A, Wang J, Scharfstein D . Prevalence of pain in patients 1 year after major trauma. Arch Surg. 2008; 143(3):282-7. DOI: 10.1001/archsurg.2007.61. View

12.

Saastamoinen P, Leino-Arjas P, Laaksonen M, Lahelma E . Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees. Pain. 2005; 114(3):364-371. DOI: 10.1016/j.pain.2004.12.033. View

13.

Heim C, Newport D, Mletzko T, Miller A, Nemeroff C . The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology. 2008; 33(6):693-710. DOI: 10.1016/j.psyneuen.2008.03.008. View

14.

Finan P, Goodin B, Smith M . The association of sleep and pain: an update and a path forward. J Pain. 2013; 14(12):1539-52. PMC: 4046588. DOI: 10.1016/j.jpain.2013.08.007. View

15.

Sturgeon J, Zautra A . Resilience: a new paradigm for adaptation to chronic pain. Curr Pain Headache Rep. 2010; 14(2):105-12. PMC: 4899321. DOI: 10.1007/s11916-010-0095-9. View

16.

Hannibal K, Bishop M . Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014; 94(12):1816-25. PMC: 4263906. DOI: 10.2522/ptj.20130597. View

17.

Bushnell M, ceko M, Low L . Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013; 14(7):502-11. PMC: 4465351. DOI: 10.1038/nrn3516. View

18.

de C Williams A, Eccleston C, Morley S . Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2012; 11:CD007407. PMC: 6483325. DOI: 10.1002/14651858.CD007407.pub3. View

19.

Linton S, Boersma K, Jansson M, Svard L, Botvalde M . The effects of cognitive-behavioral and physical therapy preventive interventions on pain-related sick leave: a randomized controlled trial. Clin J Pain. 2005; 21(2):109-19. DOI: 10.1097/00002508-200503000-00001. View

20.

Duarte Macea D, Gajos K, Daglia Calil Y, Fregni F . The efficacy of Web-based cognitive behavioral interventions for chronic pain: a systematic review and meta-analysis. J Pain. 2010; 11(10):917-29. DOI: 10.1016/j.jpain.2010.06.005. View