IntroductionMultidisciplinary pain management is a useful method for treating chronic musculoskeletal pain. Currently, few facilities in Japan offer multidisciplinary pain treatment, especially in the inpatient setting. We implemented a multidisciplinary pain management program based on International Association for the Study of Pain recommendations. This study described our initial efforts in implementing the program, and reported 3- and 6-month follow-up results.Materials and methodsOur pain management team included orthopedic surgeons, psychiatrists, nurses, physical therapists, clinical psychologists, pharmacists, and nutritionists. The 3-week inpatient pain management program comprised exercise therapy, psychotherapy, and patient education. We evaluated patients using the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Pain Disability-Assessment Scale (PDAS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), EuroQol Five Dimensions (EQ-5D), and physical examinations (flexibility, muscle endurance, walking ability, and physical fitness). Statistical analyses were performed using paired t-tests and Wilcoxon matched-pairs signed-rank sum tests with Bonferroni correction after the Friedman test.ResultsData for 23 patients were analyzed before and immediately after the program. Statistically significant improvements were seen in BPI, PCS, PDAS, HADS, PSEQ, EQ-5D, flexibility, muscle endurance, walking ability, and physical fitness. Eight patients were also assessed 3 and 6 months after the program. PCS (rumination and helplessness) scores and flexibility showed significant improvement at 3 and 6 months. Significant improvement was seen in PDAS and HADS (anxiety) scores and muscle endurance at 6 months, and in PSEQ scores immediately and at 3 and 6 months.ConclusionOur inpatient pain management program can improve patients’ physical function and ability to cope with chronic musculoskeletal pain, which supports improved quality of life. Our program is currently being expanded to better assist patients with chronic musculoskeletal pain.

Purpose. The anatomical mechanisms of cervicogenic headache caused by upper cervical lesions have been reported. However, the pathomechanisms of headache caused by lower cervical spine disorders remain unknown. The purpose of the current study was to clarify the prevalence and pathogenesis of headaches in patients with cervical spondylotic myelopathy (CSM). Methods. In this retrospective study, a questionnaire regarding preoperative and postoperative symptoms was sent to 147 patients with CSM who were surgically treated in our hospital during the previous 10 years. All of the surgical procedures were decompression surgeries between the C3 and C7 levels. Data from 74 patients (50.3%) were available for analysis. Subjects were divided into four groups according to the presence or absence of preoperative and postoperative headache. The severity of pain, severity of neuropathic pain symptoms, depression, severity of myelopathy, and quality of life (QOL) were also evaluated using questionnaires. The scores of these questionnaires were then compared between the four groups. Kruskal–Wallis tests with Dunn–Bonferroni post hoc tests were used for comparisons. Results. Of the patients with CSM, 31% had headaches preoperatively, and 43% of these headaches disappeared postoperatively. Type 4 (preoperative headache-positive/postoperative headache-positive) patients had more severe pain and neuropathic pain symptoms and lower QOL scores compared with type 1 (preoperative headache-negative/postoperative headache-negative) patients. Conclusions. Approximately one-third of all patients with CSM had headaches preoperatively. Headache in patients with CSM may be neuropathic pain. A proportion of headaches in patients with CSM can be treated by decompression surgery.

Aiming to improve postdisaster care of medical staff, we conducted an early and ongoing assessment of postdisaster psychologic distress and quality of life (QOL) in one center of a disasterresponse hospital. Twelve days after the Great East Japan Earthquake, as the Fukushima Daiichi Nuclear Power Plant crisis was unfolding, we began a survey to examine the physical and mental state of medical staff to assess their motivation toward work. Surveys were administered in March 2011

An approach of multidisciplinary pain treatment is one of the useful methods for the treatment of chronic musculoskeletal pain because of its therapeutic effectiveness, costeffectiveness, and smallness of iatrogenic complications. We are implementing a multidisciplinary pain treatment using a 3-week inpatient program based on the biopsychosocial model guided by the International Association for the Study of Pain (IASP) recommendations for such a program in Fukushima, Japan.We performed the multidisciplinary inpatient pain management program for the 28 patients (10 male and 18 female) with chronic musculoskeletal pain from April 2015 to July 2021. Twenty-eight patients were classified two types by the International Classification of Diseases 11 th Revision J (ICD-11J) as below ; 1) 12 patients (4 male and 8 female) with chronic primary pain, and 2) 16 patients (6 male and 10 female) with secondary musculoskeletal chronic pain.The purpose of this study was to examine the therapeutic effect of the multidisciplinary inpatient pain management program for 28 patients with secondary musculoskeletal chronic pain or chronic primary pain.We evaluated 1) the degrees of pain using brief pain inventory (BPI), 2) the psychosocial factors in pain using pain catastrophizing scale (PCS) (rumination, magnification, and helplessness), pain disability assessment scale (PDAS), hospital anxiety and depression scale (HADS), pain self-efficacy questionnaire (PSEQ), and 3) Quality of life (QOL) using the EuroQol Five Dimensions Questionnaire (EQ-5D) and the Athens Insomnia Scale (AIS). Statistical analyses were performed using Wilcoxon matchedpairs signed rank sum test. We considered p-values less than 0.05 to be statistically significant in the variance analyses.Comparing results before and after the program, the following statistically significant improvement in both patients with secondary musculoskeletal chronic pain and chronic primary pain were seen in PCS (magnification, helplessness, total), PDAS, HADS (anxiety, depression), PSEQ, EQ-5D. The following statistically significant improvement in only the patients with chronic primary pain were seen in BPI (p=0.017). On the other hand, the following statistically significant improvement in only the Keywords Multidisciplinary pain treatment ; Inpatient program ; International Classification of Diseases and Related Health Problem 11 th Revision

BACKGROUND: Because regular visits to distant hospitals may be a burden to patients, both in terms of time and cost, some patients with chronic musculoskeletal pain may discontinue multidisciplinary pain treatment, unable to maintain motivation to attend. OBJECTIVE: To evaluate and compare the pre-program characteristics of patients who dropped out and patients who continued treatment, thereby clarifying the characteristics of patients at risk of dropping out. METHODS: A multidisciplinary pain management treatment program was implemented for patients at the Pain Management Center, Hoshi General Hospital. From April 2015 to March 2018, 23 patients participated in the program. Twelve of the 23 patients lived outside the prefecture where the hospital is located. Of these 12 patients, five completed the program, while seven did not. We compared the dropout and continuation groups in terms of patient characteristics, pain severity, pain-related psychosocial factors, and quality of life. RESULTS: We found significant differences (p< 0.05) in median age, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire walking ability dysfunction score, and Roland-Morris Disability Questionnaire score. CONCLUSIONS: The characteristics of patients who dropped out were older age, walking ability dysfunction, and low quality of life associated with low back pain.