Chronic pain in Functional Neurological Disorders: clinical outcomes from an inpatient rehabilitation program

This study aimed to evaluate the effectiveness of an inpatient multidisciplinary program for patients diagnosed with Functional Neurological Disorder (FND) presenting with chronic pain.

Data was obtained from 100 patients with FND who completed a four-week inpatient multidisciplinary team (MDT) program between 2021 and 2023. Clinical outcomes were compared between patients presenting with chronic pain as their main symptom and those without predominant pain. The results were also compared to data collected nine years earlier.

FND patients with predominant chronic pain showed significant improvements in ratings on depression and anxiety symptoms, occupational and health status, including pain. Patients without predominant pain also significantly improved in their outcome measures. The extent of overall improvement did not differ significantly between the groups. Compared to earlier data, there was a shift from opiates to increased prescribing of neuropathic pain agents. A significant increase in referrals of FND patients with chronic pain was also observed over time.

Our findings suggest that FND patients presenting predominantly with chronic pain can benefit from inpatient multidisciplinary rehabilitation. Further research is needed to confirm these findings. Integrating a pain management team, particularly to address opiate medication use, would promote a more cohesive approach to treatment.