Interdisciplinary Pain Management Improves Interoceptive Awareness and Functional Outcomes in Chronic Pain

Research Objectives: To examine whether interoceptive awareness (IA) is improved in a homogeneous pain population following participation in an interdisciplinary pain management program. IA is altered in chronic pain; however, little is known regarding whether IA can be improved in response to pain treatment.

Design: Pre-post design. Outcomes were assessed before and after a 4–6-week interdisciplinary pain management program.

Setting: The outpatient Pain Management Center of the Shirley Ryan AbilityLab utilizing an interdisciplinary rehabilitation team (Medicine, Nursing, Psychology, Physical and Occupational Therapy).

Participants: A sample of N=27 participants completed study participation at the time of analysis. All participants were patients enrolled in the pain program meeting the following criteria: full or partial program (1-5 full days/week), ≥ 18 years old, and English speaking. Individual-only program, worker’s compensation, Postural Orthostatic Tachycardia Syndrome and Functional Neurological Disorder were excluded.

Interventions: All participants received standard of care as part of the interdisciplinary pain management program (IPMP), including a combination of individual and group therapies targeting strategies to maximize function and improve wellbeing while managing chronic pain.

Main Outcome Measures: The primary outcome was the Multidimensional Assessment of Interoceptive Awareness-Version 2 (MAIA-2). Secondary outcomes included: Patient Specific Functional Scale (PSFS), Canadian Occupational Performance Measure (COPM) and the PROMIS-Pain Interference (PI) short form.

Results: Paired sample t-tests found a significant improvement on all measures after interdisciplinary pain management: MAIA-2 total (t(25)=6.725, p<.001), COPM Performance (t(26)=6.697, p<.001), COPM Satisfaction (t(26)=6.815, p<.001), PSFS (t(22)=5.66, p<.001) and PROMIS-PI (t(25)=4.937, p<.001). Six of the 8 MAIA-2 subscales improved: Noticing, Attention Regulation, Emotional Awareness and Self-Regulation (p’s < .001), Body Listening (p=.043) and Trusting (p=.042); the two negatively worded scales did not show significant change. Mean improvements on functional outcomes were clinically meaningful (+2/10-points on COPM and PSFS; -5.2 on PROMIS-PI).

Conclusions: These findings are the first to demonstrate that IA is improved after participation in an interdisciplinary pain management program along with clinically meaningful functional rehabilitation outcomes.

Author(s) Disclosures: Nothing to disclose.