BACKGROUND: Pain intensity, functional status and beliefs and attitudes towards pain are dynamic elements involved in the experience of chronic pain. Lidocaine infusion (LI) is a therapeutic intervention used to relieve pain. OBJECTIVES: The primary objective of this study was to determine if people with chronic pain who received LI and reported a decrease in pain intensity at 4 days post-infusion differed from those who did not report a decrease in pain intensity with respect to the following: a) baseline beliefs and attitudes towards pain; b) changes in belief and attitudes towards pain; c) and changes in functional status. This study also investigated if these differences were associated with being a novel or repeat LI user. A secondary objective was to estimate the sample size required for a larger study. METHODS: This project was an exploratory study. Thirty-three subjects were monitored for pain intensity using the Visual Analogue Scale (VAS) just before the infusion, and then at four days, two weeks, and three weeks after the infusion. The subjects were separated into groups depending on the criteria of whether or not they had: a) criterion-based pain intensity decrease or not on the fourth day post infusion, and b) received a previous LI or not. Since no subjects who received their first LI reported pain intensity decrease four days later, three groups emerged from this classification: first time LI users with no pain decrease, repeat LI users with no pain decrease, and repeat LI users with pain decrease. The subjects completed two self-administered questionnaires the Survey of Pain Attitudes (SOPA-32) and the Short Musculoskeletal Function Assessment (SMFA) - before the infusion, and at two and three weeks post-infusion. The most important change at two or three weeks post-infusion was used for comparison purposes. RESULTS: No significant changes in function (SMFA) were found. However, changes in specific beliefs and attitudes towards pain (SOPA-32) were associated with the group variable as follows: 1) All three groups showed a significantly stronger belief that 'others, especially family members, should be solicitous in response to their experience of pain' after the infusion. 2) Those who received their first LI and did not report pain intensity decrease also showed a significantly stronger belief that 'medications are an appropriate treatment for chronic pain' after the infusion. 3) Subjects who had previous LI and did not report pain intensity decrease were the only ones to believe significantly less that 'medications are an appropriate treatment for chronic pain' and more 'in a medical cure for their pain problem' after the infusion. 4) Subjects who had previous LI and did report pain intensity decrease had a significantly stronger belief in the appropriateness of medications and that 'that they should avoid exercise' after the infusion. 5) Finally, subjects who believed more that 'medications are an appropriate treatment for chronic pain' and less 'that they should avoid exercise' at baseline, had significantly higher chances of experiencing decrease in pain intensity 4 days after a LI. CONCLUSION: The impact of a LI on the individuals' beliefs and attitudes towards pain differs depending if their pain intensity decreased or not four days after the infusion, and if they had previous LI or not. By contrast, their pre-infusion beliefs and attitudes profile impacts on the efficacy of this intervention. Because of the small sample size, the heterogeneity of the subjects in terms of the localization of their pain, and our choice of measurement tool, it is not possible to determine if LI impacts on function. Nevertheless, this exploratory study generated some novel observations and questions that are of great interest for future research. A particular question of interest would be to determine if repeated LI fosters a more passive attitude towards pain management. It was also determined that a sample size of 70 subjects per group would be necessary for future research on this question. / Keywords: Chronic pain, lidocaine, beliefs and attitudes towards pain, function, pain intensity.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.116097 |
| Date | January 2009 |
| Creators | Masse, Julie. |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (School of Physical and Occupational Therapy.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 003163611, proquestno: AAIMR67039, Theses scanned by UMI/ProQuest. |
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