Clinical and Psychological Impact of Chronic Pain in People with Chronic Obstructive Pulmonary Disease

Abstract

Purpose

The presence of pain can be associated with an exaggerated negative cognitive and emotional response, leading to worsening of existing symptoms. This study aimed to describe the multifaceted impact of chronic pain on cognition, emotional and physical health in people with chronic obstructive pulmonary diseases (COPD) and to explore the clinical impact of pain.

Patients and Methods

A prospective, cross-sectional multicenter study was carried out in 68 people with COPD (COPD group) and 65 community-dwelling age-matched participants (control group). Participants were assessed for the presence of chronic pain, pain location, intensity and catastrophizing, pain-related fear (kinesiophobia), anxiety and depression, physical activity, and sleep duration. The COPD group also completed assessments of dyspnea, exercise tolerance (6-minute walk distance [6MWD]), and activities of daily living (ADL).

Results

The prevalence of pain was higher in the COPD group (85% vs 51%, p<0.001). The COPD group reported pain located in neck/shoulder, upper back, thorax and upper limbs, while the control group had more pain in the lower back. Pain catastrophizing and kinesiophobia were reported by 28% and 67% vs 9% and 42%, in the COPD and control groups respectively (both p<0.05). People with COPD and pain (n=58) reported greater dyspnea (p<0.001), and impairment in ADL (p<0.05), and lower 6MWD and physical activity (both p<0.01) compared to COPD participants without pain (n=10).

Conclusion

This study demonstrated that, compared to community-dwelling participants, there is a higher prevalence of chronic pain in people with COPD. Pain combined with dyspnea may impact adversely on cognitive function and lead to anxiety and depression, as well as greater impairment in exercise tolerance, physical activity, and ADL. These results suggested that it is necessary to assess the symptoms of chronic pain and inflect in chronic pain coping strategies.

Keywords:

• chronic obstructive pulmonary disease
• chronic pain
• cognitive function
• physical function
• dyspnea

Data Sharing Statement

Data used to support the findings of this study are included within the manuscript in Tables 1–3 and Figure 2. Raw data are available from the corresponding author upon reasonable request.

Acknowledgments

The authors were grateful to the study participants, physiotherapists who acquired data for the study from Department of Rehabilitation, Hozenkai Tagami Hospital; Department of Rehabilitation, Kirigaoka Tsuda Hospital; Department of Rehabilitation; Utsunomiya Medical Clinic and Special Elderly Nursing Home Keijyuen.

Author Contributions

TT, MO and RK contributed significantly to conception and design, or analysis and interpretation of data; and have been involved in drafting and reviewing the manuscript. SJ contributed significantly to analysis and interpretation data and has been involved in drafting and revised it critically for important intellectual content. All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. All named authors had given final approval of the version to be published.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The study design, collection and analysis of the data, and preparation of the manuscript were not funded by any public, commercial, or not-for-profit sectors.