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Graded chronic pain status: an epidemiologic evaluation.
Michael Von Korff1, Samuel F Dworkin, Linda Le Resche
1Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98121 U.S.A. Department of Oral Medicine, School of Dentistry, University of Washington, Seattle, WAU.S.A. Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WAU.S.A.
Pain
|March 1, 1990
Summary
A new classification system for chronic pain was developed, categorizing pain by time, severity, and impact. This grading helps understand chronic pain burden and guides effective interventions for better patient outcomes.
Area of Science:
- Epidemiology
- Pain Research
- Public Health
Background:
- Differentiating chronic pain states (recurrent, persistent, disabling) is crucial for understanding burden, natural history, and interventions.
- Current classifications may not fully capture the complexity of chronic pain experiences.
- Population-based data is needed to develop and evaluate robust pain status classifications.
Purpose of the Study:
- To develop and evaluate a graded classification system for chronic pain status.
- To assess the prevalence of different chronic pain severity and impact levels in a population sample.
- To examine the associations between graded chronic pain status and related health outcomes.
Main Methods:
- A probability sample of 1016 health maintenance organization enrollees was surveyed.
- A graded classification system for chronic pain was developed based on time, severity, and impact (disability, dysfunction).
- Statistical analyses were used to determine prevalence and associations.
Main Results:
- Recurrent or persistent pain affected 45% of the sample; severe and persistent pain affected 8%.
- Severe, persistent pain with activity limitation and dysfunction was present in 1.0% of the population.
- Graded chronic pain status correlated with psychological impairment, poor health appraisal, and increased healthcare/medication use.
Conclusions:
- A three-axis grading system (time, severity, impact) effectively categorizes chronic pain.
- This classification aids in understanding the burden and natural history of chronic pain.
- The system highlights the heterogeneity of pain dysfunction despite comparable pain experiences.