Effectiveness of patient education focusing on circadian pain rhythms: A case report and review of literature

Abstract

BACKGROUND Neuropathic pain management should aim at improving quality of life and daily living activities of patients; therefore, emphasis should be placed on pain management including understanding the pain patterns during daily activity. Therefore, lifestyle guidance should be based on a detailed understanding of pain; however, previous studies commonly evaluated pain intensity at a single point in time. We report a case on patient education intervention based on the relationship between pain circadian rhythms and detailed physical activity during the day. CASE SUMMARY A man in his 60s, who suffered a brachial plexus injury in a traffic accident, presented with neuropathic pain. Early assessment of the importance of daily living activities to the patient, pain rhythmicity, and physical activity, was performed. The early assessments showed that the pain intensity was lower on days when more light-intensity physical activity (LIPA) was performed, than on days when less LIPA was performed. Consequently, patient education focused on methods to decrease the pain intensity that tended to worsen in the afternoon, and encouraged behavioral changes by suggesting the patient to take walks,” which could be used to maintain LIPA in the afternoon. On reassessment, the afternoon LIPA, which had been the focus of attention, had increased and a change was noted in the circadian rhythm of pain. CONCLUSION Patient education based on a composite assessment elicited positive results in relation to the pain circadian rhythm and physical activity.

Can the Assessment of the Circadian Rhythm of Pain Be Shortened? A Study of Community-Dwelling Participants with Chronic Pain

“…Patient education aimed at pain management rooted in an understanding of the circadian rhythm of pain has led to a reduction in pain intensity and an increase in daytime physical activity levels. 23 …”

“…Patient education aimed at pain management rooted in an understanding of the circadian rhythm of pain has led to a reduction in pain intensity and an increase in daytime physical activity levels. 23 Thus, it is imperative to integrate the pain circadian rhythm into the evaluation of patients with chronic pain and contemplate treatment modalities accordingly. Nevertheless, the current landscape is characterized by reports on several treatment strategies that consider the circadian rhythm of pain, which makes it challenging to assert that the circadian rhythm of pain has firmly established itself as an evaluation criterion for chronic pain therapy.…”