Painful bone metastases: a prospective observational cohort study

Incident pain related to bone metastases is a problematic symptom to treat. The difficulty in treating this type of pain is reflected in the wide variety of treatment modalities recommended. The aims of this prospective observational study were to determine the patterns of pain severity at rest and on movement over time and which treatment modalities are employed. In addition, we were interested in ascertaining any correlations between bone pain at rest, bone pain on movement and functional ability. Thirty-two patients were followed up for a mean of 22 weeks (range: 2-52). In total, there were 704 patient follow-up weeks. Patients were followed up for one year or until death. A total of 19 different treatment modalities were employed. There were strong correlations between pain at rest and pain on movement. There were no significant correlations between functional ability and pain at rest or movement. Our study demonstrates the complex management of patients with bone pain. This is the first study that highlights the correlation between pain at rest and pain on movement in patients with bone metastases in a palliative care population. It highlights the need for intensive follow-up of these patients, as they require multiple interventions to help control their pain. These data can also be used to power further interventional studies.