Pain characteristics and self-rated health after elective orthopaedic surgery - a cross-sectional survey.

AIMS AND OBJECTIVES

To describe the postoperative pain and to examine the relationship between pain intensity, pain interference and self-rated health after elective orthopaedic surgery.

BACKGROUND

Pain is a problem for many surgical inpatients and can lead to postoperative complications. Limited knowledge exists about the relationship between postoperative pain, function and self-rated health.

DESIGN

Cross-sectional survey.

METHODS

Pain characteristics, self-rated health, sociodemographic status and comorbidity were measured in 123 elective orthopaedic inpatients recruited consecutively from a hospital in eastern Norway in 2012. On the day they were discharged from the surgical unit, patients completed items about pain intensity and pain interference from the Brief Pain Inventory and about self-rated health from the Medical Outcome Short Form-36 Health Survey. Clinical data were retrieved from the medical records. Patients were divided into three diagnostic groups: shoulder surgery, hip or knee replacement and other surgery.

RESULTS

Mean age was 60 years (SD 17·2) and 50% were females. Average pain intensity was 4·2 (SD 2·2) on a 0-10 numeric rating scale and 60% reported moderate/severe pain during the entire hospital stay. Shoulder surgery patients reported significantly higher pain intensity compared to other surgical groups. Pain interfered mostly with daily activity and sleep. Higher pain intensity was significantly associated with poorer self-rated health. The linear regression analysis showed that average pain intensity was related to poorer self-rated health, controlling for sociodemographic variables and pain interference with function.

CONCLUSION

High pain intensity is related to poorer self-rated health. Postoperative pain is undermanaged, affects functional areas and could delay rehabilitation.

RELEVANCE TO CLINICAL PRACTICE

Postoperative pain management should be given high priority after elective orthopaedic surgery, in order to improve self-rated health and function. Pain treatment for shoulder surgery patients may require more attention than it currently receives.