ASSESSMENT OF PAIN DURING ACTIVITY, AT REST AND AT NIGHT – DO WE HAVE TO ASSESS ALL THREE DIFFERENT PAINS?

Abstract

Introduction: Pain is arguably the most important symptom in the musculoskeletal system. When taking the patient’s history or using patient-questionnaires, pain during activity, at rest and at night are assessed separately, then amalgamated to a composite score. From our experience in regular use of a standardized anamnesis method (interactive anamnesis with Pationnaire), we have gained the impression that pain at rest and night pain might correlate. The aim of this study was to find out if there is a correlation between pain during activity, pain at rest and pain at night.

Patients and Methods: Patients with a variety of disorders of the musculoskeletal system (degenerative pathologies of all major joints, cervical and lumbar spine, multifocal pain syndromes) completed a validated simple patient questionnaire (Pationnaire) during routine consultations. This patient questionnaire allows measurement and documentation of 10 cardinal symptoms and disabilities regarding sleep and normal daily life. All the questionnaires were scanned and filed. The data of more than 1000 observations were statistically analyzed by an external statistical institute for correlations of symptoms using Spearman correlation coefficients.

Results: Included were 938 patients with 1160 observations between October 2006 and June 2008. Average age was 58.9 years, 54% of them were women. Average pain during activity was 59.3, at rest 36.9 and at night 35.6. We found a positive correlation of 0.79 between pain at rest and at night. The correlation coefficient between pain during activity and pain at rest was 0.58, and that between pain during activity and at night was 0.47 (p< 0.05).

Conclusion: Pain at rest and at night, as assessed in a patient questionnaire, are positively correlated. In a questionnaire, these two kinds of pain could be assessed with one single question, i.e. it may be enough to assess and document pain during activity and at rest/night.